Individual provider Active NPI

Svjetlana Tisma-Dupanovic, MD

  • Pediatric Cardiology Physician
  • Kansas City, MO
National Provider Identifier
1194920918
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
2007026050 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
NPI assigned
Jun 20, 2007
Last updated
Mar 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 2007026050 MO Primary
Pediatric Cardiology Physician 2080P0202X 04-32774 KS

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

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
I20201223001084 FL Practitioner - Cardiovascular Disease (Cardiology) 9335235001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nemours FoundationGroup PAC ID 9537072483, 249 clinicians

Practice addresses (Care Compare)

6535 Nemours Pkwy
Orlando, FL 32827-7884
Phone (407) 567-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007026050MOMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Dec 21, 2020 Accepting new patients
The Nemours Foundation CurrentSince Dec 21, 2020 Accepting new patients

Locations

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1270 N Wickham Rd
Melbourne, FL 32935
Phone (321) 266-8251

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

Interoperability endpoints

  • Direct secure messaging: stismadupanovic84180@direct.nemours.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1194920918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISMA-DUPANOVIC",
        "first_name": "SVJETLANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2007026050",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KS",
            "license": "04-32774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.