Active NPI
Zack Belmundo Miller, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1811187552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 017246
- Practice address
- 227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537 - Phone
- (212) 238-7614
- Fax
- (212) 238-7009
- NPI assigned
- Jul 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 017246 | NY | Primary |
Addresses
Primary practice location
227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537
Mailing address
227 Madison St
Medical Staff Office, R-1249
New York, NY 10002-7537
Phone (212) 238-7614
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017264 | Other | NY | NYS LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017246 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1811187552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 MADISON ST",
"address_2": "MEDICAL STAFF OFFICE, R-1249",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100027537",
"telephone_number": "212-238-7614",
"fax_number": "212-238-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 MADISON ST",
"address_2": "MEDICAL STAFF OFFICE, R-1249",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100027537",
"telephone_number": "212-238-7614",
"fax_number": "212-238-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ZACK",
"middle_name": "BELMUNDO",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-30",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "017246",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LICENSE NUMBER",
"identifier": "017264",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.