Individual provider Active NPI

Mirjana Stancic, MD

  • Internal Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1073656963
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301074624 Issued in MI
Practice address
601 John St # 74
Kalamazoo, MI 49007-5341
Phone
(269) 341-8481
Fax
(269) 341-7781
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 4301074624 MI
Internal Medicine Physician 207R00000X 4301074624 MI Primary

Addresses

Primary practice location

601 John St # 74
Kalamazoo, MI 49007-5341

Mailing address

5943 Stadium Dr
Kalamazoo, MI 49009-3016

Other practice location 1

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20050930000217 MI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 1355376096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

300 N Ave
Battle Creek, MI 49017-3307
Phone (888) 258-0875

601 John St
Kalamazoo, MI 49007-5341

601 John St
Kalamazoo, MI 49007-5377

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301074624MIMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital CurrentSince Jul 1, 2005 Accepting new patients
Ascension Borgess Hospital Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Promed Healthcare CurrentSince Jan 1, 2012 Accepting new patients
Bronson Lakeview Hospital Hospice and Palliative Medicine CurrentSince Jan 2, 2018 Accepting new patients
Bronson Lakeview Hospital Internal Medicine CurrentSince Jan 2, 2018 Accepting new patients
Bronson Methodist Hospital CurrentSince Jan 2, 2018 Accepting new patients
Ascension Medical Group Promed Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients
Ascension Borgess Hospital Current Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Ascension Medical Group Promed Internal Medicine Current Accepting new patients
Bronson Methodist Hospital Past Accepting new patients
Bronson Battle Creek Hospital Past Accepting new patients

Locations

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

601 John St
#47
Kalamazoo, MI 49007

5943 Stadium Dr
Kalamazoo, MI 49009
Phone (269) 280-4586

601 John St
#74
Kalamazoo, MI 49007
Phone (269) 341-8481

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1073656963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 74",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Gull Rd",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481640",
            "country_code": "US",
            "telephone_number": "269-226-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANCIC",
        "first_name": "MIRJANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301074624",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301074624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.