Active NPI
Gavro Jelic
- Internal Medicine Physician
- Bronx, NY
National Provider Identifier
1134737786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 76530
- Practice address
- 130 W Kingsbridge Rd
Bronx, NY 10468-3904 - Phone
- (718) 584-9000
- NPI assigned
- Jul 20, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 76530 | CT | Primary |
Addresses
Primary practice location
130 W Kingsbridge Rd
Bronx, NY 10468-3904
Mailing address
130 W Kingsbridge Rd
Bronx, NY 10468-3904
Phone (718) 584-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240613000755 | CT | Practitioner - Internal Medicine | 9234671611 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Windham Community Memorial Hospital Inc
Practice addresses (Care Compare)
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-9116
Hospital & facility affiliations
- Windham Community Memorial Hospital
- William W Backus Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windham Community Memorial Hospital, Inc. | Current | Accepting new patients |
Locations
112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410
Interoperability endpoints
- gavro.jelic@xdr.hhchealthdirect.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Willimantic, CT
- NPI 1023191467
CT
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Willimantic, CT
- NPI 1023191467
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760918400000",
"number": "1134737786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 W KINGSBRIDGE RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104683904",
"telephone_number": "718-584-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W KINGSBRIDGE RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104683904",
"telephone_number": "718-584-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELIC",
"first_name": "GAVRO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-20",
"last_updated": "2025-10-20",
"certification_date": "2025-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "76530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.