Individual provider Active NPI

Vasilije Mijovic, M.D

  • Anesthesiology Physician
  • Hartford, CT
National Provider Identifier
1245688191
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
66764 Issued in CT
Practice address
100 Retreat Ave Ste 900
Hartford, CT 06106-2553
Phone
(860) 218-2204
Fax
(860) 461-0224
NPI assigned
Jun 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 66764 CT Primary

Addresses

Primary practice location

100 Retreat Ave Ste 900
Hartford, CT 06106-2553

Mailing address

100 Retreat Ave Ste 900
Hartford, CT 06106-2553
Phone (860) 218-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210208001017 CT Practitioner - Anesthesiology 6406260280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

65 Memorial Rd
Suite 500
West Hartford, CT 06107-4233
Phone (860) 586-8655

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66764CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients

Locations

505 Farmington Ave
Farmington, CT 06032
Phone (860) 837-6700

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

100 Retreat Ave
Ste 900
Hartford, CT 06106
Phone (860) 218-2204

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (860) 282-4128

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1245688191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE STE 900",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062553",
            "telephone_number": "860-218-2204",
            "fax_number": "860-461-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE STE 900",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062553",
            "telephone_number": "860-218-2204",
            "fax_number": "860-461-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJOVIC",
        "first_name": "VASILIJE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "66764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.