Individual provider Active NPI

Ranko Miocinovic, M.D.

  • Urology Physician
  • Lombard, IL
National Provider Identifier
1164687539
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036137902 Issued in IL
Practice address
1801 S Highland Ave Ste 220
Lombard, IL 60148-4932
Phone
(630) 790-1221
NPI assigned
Jul 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35.094165 OH
Urology Physician 208800000X 036137902 IL Primary

Addresses

Primary practice location

1801 S Highland Ave Ste 220
Lombard, IL 60148-4932

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036137902MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rmiocinovic49114@direct.edward.org
Direct Messaging Address rmiocinovic49114@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150714000630 IL Practitioner - Urology 2365598745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Toledo College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1020 E Ogden Ave
Suite 301
Naperville, IL 60563-8609
Phone (630) 653-1091

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.094165OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Shockwave Services, LTD. Urology CurrentSince Dec 10, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 1, 2015 Accepting new patients
United Shockwave Services, LTD. CurrentSince Dec 10, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 1, 2015 Accepting new patients
DMG Surgical Center LLC Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

120 N La Grange Rd
La Grange, IL 60525
Phone (630) 226-1436

430 Warrenville Rd
Ste 110
Lisle, IL 60532
Phone (630) 946-2020

2725 Technology Dr
Lombard, IL 60148
Phone (630) 348-3300

1801 S Highland Ave
Ste 220
Lombard, IL 60148
Phone (630) 873-8700

1020 E Ogden Ave
Ste 301
Naperville, IL 60563
Phone (630) 545-7565

1875 W Dempster St
Ste G04
Park Ridge, IL 60068
Phone (630) 684-9361

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

6701 159th St
Tinley Park, IL 60477
Phone (708) 429-0222

815 Pasquinelli Dr
Westmont, IL 60559
Phone (630) 366-7854

Interoperability endpoints

  • Direct secure messaging: rmiocinovic49114@direct.edward.org

Organizations & group practices 5

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 5

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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1164687539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S HIGHLAND AVE STE 220",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484932",
            "telephone_number": "630-790-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIOCINOVIC",
        "first_name": "RANKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.094165",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036137902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036137902",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmiocinovic49114@direct.edward.org",
            "affiliation": "N",
            "address_1": "1801 S Highland Ave Ste 220",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmiocinovic49114@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1801 S Highland Ave Ste 220",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.