Active NPI
Dajana Vidovic, DPT
- Physical Therapist
- Jamaica, NY
National Provider Identifier
1053135400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 045826-01
- Practice address
- 8940 135TH St
Jamaica, NY 11418-2828 - Phone
- (315) 527-3259
- NPI assigned
- Nov 12, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 045826-01 | NY | Primary |
Addresses
Primary practice location
8940 135TH St
Jamaica, NY 11418-2828
Mailing address
53 Saint Nicholas Ave Apt 1E
New York, NY 10026-3426
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045826-01 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1053135400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 SAINT NICHOLAS AVE APT 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100263426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8940 135TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114182828",
"telephone_number": "315-527-3259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDOVIC",
"first_name": "DAJANA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-12",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "045826-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.