NPIMap

Individual provider Active NPI

Miroslav Djokic, M.D.

  • Pulmonary Disease Physician
  • Amityville, NY
National Provider Identifier
1023048865
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A87463 Issued in CA
Practice address
221 Broadway
Suite 204
Amityville, NY 11701-2780
Phone
(631) 598-5864
Fax
(631) 598-5866
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A87463 CA Primary

Addresses

Primary practice location

221 Broadway
Suite 204
Amityville, NY 11701-2780

Mailing address

221 Broadway
Suite 204
Amityville, NY 11701-2780
Phone (631) 598-5864

Other identifiers 1

IdentifierTypeStateIssuer
00A874630MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803001554 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1850362849 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Joaquin Critical Care Medical Group, Inc.Group PAC ID 8628325123, 9 clinicians
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

1801 E March Lane
Suite C300
Stockton, CA 95210-6657

1801 E March Lane
Suite C300
Stockton, CA 95210-6676
Phone (209) 464-6422

1801 E March LN
Suite C300
Stockton, CA 95210-6657

193 Fairview LN
Sonora, CA 95370-4828
Phone (209) 536-5100

900 Greenley Rd
Suite 923
Sonora, CA 95370-5287
Phone (209) 536-3730

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335
  • Dameron Hospital Hospital, Stockton, CA, CCN 050122
  • Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118
  • Sutter Tracy Community Hospital Hospital, Tracy, CA, CCN 050313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A87463CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Mar 10, 2025 Accepting new patients
Sonora Community Hospital CurrentSince Mar 10, 2025 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital Pulmonary Disease CurrentSince Mar 10, 2025 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Amityville Pulmonology PLLC Pulmonary Disease PastSince Jun 3, 2005 Accepting new patients
Dameron Hospital Association Past Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Sonora Community Hospital Past Accepting new patients
Mohammad S Hussain MD PC Past Accepting new patients
Lodi Memorial Hospital Association Inc Past Accepting new patients
Port City Operating Company, LLC Past Accepting new patients

Locations

900 Greenley Rd
Ste 923
Sonora, CA 95370
Phone (209) 536-5090

193 Fairview Ln
Ste C
Sonora, CA 95370
Phone (209) 532-3124

12811 Covey Cir
Sonora, CA 95370
Phone (209) 536-1785

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABHECD/Endpoint/ABHECD

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1023048865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 204",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012780",
            "telephone_number": "631-598-5864",
            "fax_number": "631-598-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 204",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012780",
            "telephone_number": "631-598-5864",
            "fax_number": "631-598-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOKIC",
        "first_name": "MIROSLAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A87463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A874630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.