Individual provider Active NPI

Susan Miller, M.D.

  • Family Medicine Physician
  • Ithaca, NY
National Provider Identifier
1871517946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201726-1 Issued in NY
Practice address
110 Ho Plaza
Gannett Health Services Cornell University
Ithaca, NY 14853-3101
Phone
(607) 255-6946
Fax
(607) 254-3503
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 201726-1 NY Primary

Addresses

Primary practice location

110 Ho Plaza
Gannett Health Services Cornell University
Ithaca, NY 14853-3101

Mailing address

110 Ho Plaza
Gannett Health Services Cornell University
Ithaca, NY 14853-3101
Phone (607) 255-6946

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 Medicine

State licenses

LicenseStateTypeSpecialty
201726-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell University Past Accepting new patients
Cornell University Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871517946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "address_2": "GANNETT HEALTH SERVICES CORNELL UNIVERSITY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533101",
            "telephone_number": "607-255-6946",
            "fax_number": "607-254-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLAZA",
            "address_2": "GANNETT HEALTH SERVICES CORNELL UNIVERSITY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533101",
            "telephone_number": "607-255-6946",
            "fax_number": "607-254-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "201726-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.