Individual provider Active NPI

David Miller, O.D.

  • Optometrist
  • Yonkers, NY
National Provider Identifier
1821166570
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003193 Issued in NY
Practice address
87 N. Cross Cnty Pkwy
Sears Optical
Yonkers, NY 10704
Phone
(914) 377-2168
Fax
(914) 709-1970
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003193 NY Primary
Optometrist 152W00000X 270A00341300 NJ
Optometrist 152W00000X OE004798L PA
Optometrist 152W00000X OPT 6512 CA

Addresses

Primary practice location

87 N. Cross Cnty Pkwy
Sears Optical
Yonkers, NY 10704

Mailing address

517 Martling Ave
Tarrytown, NY 10591-4718
Phone (914) 767-0487

Other identifiers 2

IdentifierTypeStateIssuer
00539033MedicaidNY
A300023278OtherNYMEDICARE PTAN #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412001672 NY Practitioner - Optometry 6709870843 Practice locations: Yonkers, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 6512CAMDOptometrist
270A00341300NJMDOptometrist
TUV003193NYMDOptometrist
OE004798LPAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1821166570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 MARTLING AVE",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914718",
            "telephone_number": "914-767-0487",
            "fax_number": "914-767-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 N. CROSS CNTY PKWY",
            "address_2": "SEARS OPTICAL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10704",
            "telephone_number": "914-377-2168",
            "fax_number": "914-709-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003193",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00341300",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE004798L",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 6512",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00539033",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "A300023278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.