Individual provider Active NPI

Radomir Kosanovic, MD

  • Physical Medicine & Rehabilitation Physician
  • South Miami, FL
National Provider Identifier
1184055303
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME152087 Issued in FL
Practice address
6200 Sunset Dr Ste 120
South Miami, FL 33143-4832
Phone
(786) 596-3876
Fax
(786) 533-9989
NPI assigned
Dec 13, 2013
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME152087 FL Primary
Physical Medicine & Rehabilitation Physician 208100000X 18382 WI
Physical Medicine & Rehabilitation Physician 208100000X 036143746 IL
Physical Medicine & Rehabilitation Physician 208100000X 53208 KY
Interventional Pain Medicine Physician 208VP0014X ME152087 FL
Interventional Pain Medicine Physician 208VP0014X 01083026A IN
Interventional Pain Medicine Physician 208VP0014X 53028 KY
Interventional Pain Medicine Physician 208VP0014X 36.143746 IL

Addresses

Primary practice location

6200 Sunset Dr Ste 120
South Miami, FL 33143-4832

Mailing address

PO Box 198054
Atlanta, GA 30384-8054
Phone (786) 596-3876

Other identifiers 3

IdentifierTypeStateIssuer
QMP000005573901MedicaidIL
7100644790MedicaidKY
300033818MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RAD06910@cerner.directbaptisthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220202001387 FL Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 9133495229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabclinics Pta IncGroup PAC ID 0547237497, shared by 11 NPIs, 209 clinicians
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

13645 Biscayne Blvd
North Miami Beach, FL 33181-1617
Phone (305) 949-2700

6200 SW 72ND St
Suite 120
South Miami, FL 33143-4832
Phone (786) 596-3876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18382WIMDPhysical Medicine & Rehabilitation Physician
53028KYMDNeurology Physician
36.143746ILMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Physicians LLC CurrentSince Sep 5, 2023 Accepting new patients
Anesthesia Dynamics LLC Interventional Pain Medicine Past Accepting new patients

Locations

6200 Sunset Dr
Ste 120
South Miami, FL 33143
Phone (786) 662-4715

6200 Sunset Dr
Ste 604
South Miami, FL 33143
Phone (305) 853-9240

Interoperability endpoints

  • Direct secure messaging: rad06910@cerner.directbaptisthealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1184055303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054",
            "telephone_number": "786-596-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SUNSET DR STE 120",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434832",
            "telephone_number": "786-596-3876",
            "fax_number": "786-533-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSANOVIC",
        "first_name": "RADOMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-13",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME152087",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "18382",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036143746",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "53208",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME152087",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01083026A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "53028",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "36.143746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QMP000005573901",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100644790",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033818",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RAD06910@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "6200 Sunset Dr Ste 120",
            "city": "South Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331434832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.