Sidika Kajtezovic

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

89 Beaumont Ave
Burlington, VT 05405-1742

Phone

(802) 656-2154

NPI assigned

Apr 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Vermont College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Suburban Massachusetts IncGroup PAC ID 0244133494, 534 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kajtezovic.sidika.nwh@direct.partners.masshiway.net
• Direct secure messaging: skajtezovic140607@direct.bmc.masshiway.net

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.

• Mass General Brigham Medical Group Suburban Massachusetts Inc

  • Family Medicine Physician
  • Newton, MA
  • NPI 1538191218
  Medicare reassignment Care Compare group NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Newton Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1952845521
  NPD

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

• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation

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

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1053930941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182999",
            "telephone_number": "617-414-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 BEAUMONT AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054051742",
            "telephone_number": "802-656-2154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 East Ave Apt 2",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054013592",
            "country_code": "US",
            "telephone_number": "315-762-3959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAJTEZOVIC",
        "first_name": "SIDIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-11",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Angelo Kakos, DO
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• Lara Marie Kalix-Crisafi, NP
• Amanda Nicole Kallen, MD

• Student in an Organized Health Care Education/Training Program in Burlington, VT
• Providers in Burlington, VT by specialty
• Student in an Organized Health Care Education/Training Program in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.