Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeremy Tetsuo Miyauchi, MD/PHD

Individual provider Anatomic Pathology Physician · NPI 1114480282

Dr. Jeremy Tetsuo Miyauchi, MD/PHD is a Pathology in Mount Kisco, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 2019, 7 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
7
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2019

Practice location Address checks out

400 E Main St
Mount Kisco, NY 10549-3477
Phone: (914) 666-1200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 520 E 70th St, New York, NY 10021-9800 — (646) 689-4050
  • 701 N Broadway, Sleepy Hollow, NY 10591-1096 — (914) 366-3000

Specialties & licences

Anatomic Pathology Physician (primary) Taxonomy 207ZP0101X · Licence 313523 (NY)

Record details

NPI number1114480282
Entity typeIndividual (Type 1)
GenderMale
Credentials MD/PHD
Sole proprietorNo
NPI enumeratedApril 7, 2019
Last updated in NPPESFebruary 22, 2023
Certification dateFebruary 22, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mount Kisco