Active NPI
Jean D. Miller, DO
- General Practice Physician
- New York, NY
National Provider Identifier
1942940101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 166662-A
- Practice address
- 4996 Broadway 4D
New York, NY 10034 - Phone
- (212) 569-4353
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 166662-A | NY | Primary |
Addresses
Primary practice location
4996 Broadway 4D
New York, NY 10034
Mailing address
4996 Broadway
4D
New York, NY 10034
Phone (212) 569-4353
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166662-A | NY | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1942940101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4996 BROADWAY",
"address_2": "4D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10034",
"telephone_number": "212-569-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4996 BROADWAY 4D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10034",
"telephone_number": "212-569-4353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JEAN",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "166662-A",
"primary": true
}
],
"identifiers": [],
"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 Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.