NPIMap

Individual provider Active NPI

Dusan Dragovic, M.D.

  • Nephrology Physician
  • Coconut Creek, FL
National Provider Identifier
1245285212
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME89623 Issued in FL
Practice address
5300 W Hillsboro Blvd
Suite 206
Coconut Creek, FL 33073-4395
Phone
(954) 420-9908
Fax
(954) 420-9911
NPI assigned
May 24, 2006
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME89623 FL Primary

Addresses

Primary practice location

5300 W Hillsboro Blvd
Suite 206
Coconut Creek, FL 33073-4395

Mailing address

5300 W Hillsboro Blvd
Suite 206
Coconut Creek, FL 33073-4395
Phone (954) 420-9908

Other identifiers 2

IdentifierTypeStateIssuer
270686500MedicaidFL
48375ZOtherFLMEDICARE ID

Other names 1

  • Dusan Dragovic Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000923 FL Practitioner - Nephrology 6507831385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5300 W Hillsboro Blvd
Suite 206
Coconut Creek, FL 33073-4395
Phone (954) 420-9908

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME89623FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dusan Dragovic, MD, Fasn, LLC Nephrology CurrentSince Feb 10, 2012 Accepting new patients
Kidney Group of South Florida PA PastSince Oct 23, 1995 Accepting new patients

Locations

5300 W Hillsboro Blvd
Ste 206
Coconut Creek, FL 33073
Phone (954) 420-9908

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 8

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1245285212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W HILLSBORO BLVD",
            "address_2": "SUITE 206",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734395",
            "telephone_number": "954-420-9908",
            "fax_number": "954-420-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W HILLSBORO BLVD",
            "address_2": "SUITE 206",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734395",
            "telephone_number": "954-420-9908",
            "fax_number": "954-420-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGOVIC",
        "first_name": "DUSAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME89623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270686500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "48375Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DUSAN",
            "last_name": "DRAGOVIC",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.