Individual ProviderIvan MillerEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1 Clara Maass Dr, Clara Maass Medical Center (Emergency Department), Belleville, NJ 07109-3550(973) 450-2100(973) 740-0607PECOS EnrollmentBased on the most recent information from CMS, provider Ivan Miller is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1235176512Provider TypeIndividualFull NameMiller, IvanCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/2/2006Last Updated1/15/2025Contact InformationPractice LocationPractice Address1 Clara Maass Dr, Clara Maass Medical Center (Emergency Department), Belleville, NJ 07109-3550Phone(973) 450-2100FaxUnlisted FaxMailing LocationMailing AddressPO Box 717, Livingston, NJ 07039-0717Phone(973) 740-0607FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense217211New YorkCode207P00000XDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense25MA07413300New JerseyProvider IdentifiersIDDescriptionIssuerID8852901DescriptionMedicaidIssuerUnlistedNew Jersey