Stephen J Miro, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

015314 Issued in NY

Practice address

694 Motor Parkway
Hauppauge, NY 11788

Phone

(631) 265-9355

NPI assigned

Oct 31, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Preferred Professional Medical Care PC

  • Internal Medicine Physician
  • Ronkonkoma, NY
  • NPI 1083916670
  Medicare reassignment

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1881970234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 JEFFERSON STREET",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "11767",
            "telephone_number": "631-428-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 MOTOR PARKWAY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "631-265-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRO",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Rodriguez, MD Medical Services, PC
• Gail V Mickaliger, RPH
• Jillian Mikolajczyk-Demarco, DPT
• Damiano Milana Jr.
• Joshua David Miller, M.D., M.P.H.
• Vivien Misshula, LMSW
• William Joseph Mitrus, DC CCSP
• MK Spine and Joint Rehab, P.C.
• Melissa Modica
• Victoria Moir, MHC-LP

• Medical Physician Assistant in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.