Individual provider Active NPI

Nevena Radonjic, M.D., PHD

  • Psychiatry Physician
  • Syracuse, NY
National Provider Identifier
1245644756
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
291798 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-3445
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 291798 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

263 Farmington Ave
Farmington, CT 06032-1956

Other practice location 1

263 Farmington Ave
Farmington, CT 06032-1956
Phone (860) 679-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180730002353 NY Practitioner - Psychiatry 6709134331 Reassigns benefits to 1 organization
I20201110000015 TX Practitioner - PsychiatryPractitioner - NeurologyPractitioner - Neuropsychiatry 6709134331

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology, Neuropsychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneida Indian Health ServicesGroup PAC ID 9133254584, 9 clinicians
Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians

Practice addresses (Care Compare)

2037 Dream Catcher PLZ
Oneida, NY 13421-2729

2057 Dream Catcher Plaza
Oneida, NY 13421-2729

2057 Dream Catcher PLZ
Oneida, NY 13421-2729

713 Harrison St
BLDG 3
Syracuse, NY 13210-2305
Phone (315) 464-3265

Merit-based Incentive Payment System (MIPS)

Final score
94.28 of 100Reported as group
Quality
88.2
Promoting interoperability
100
Improvement activities
40
Cost
69.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Faculty Practice, Inc. Psychiatry CurrentSince Aug 1, 2018 Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

713 Harrison St
Syracuse, NY 13210
Phone (315) 464-3145

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

Interoperability endpoints

  • Direct secure messaging: nradonjic83651@direct.upstate.edu
  • Direct secure messaging: nradonjic@hiemail.healtheconnections.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1245644756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADONJIC",
        "first_name": "NEVENA",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "291798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.