Individual provider Active NPI

Milos Marjanovic, M.D.

  • Specialist
  • Detroit, MI
National Provider Identifier
1275574063
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301075660 Issued in NU
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8521
NPI assigned
Jun 10, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301075660 NU Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

4160 John R St
Suite 522
Detroit, MI 48201-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20051017000856 MI Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 5799701066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Surgical Center of Dearborn LLCGroup PAC ID 6204149586, shared by 2 NPIs, 3 clinicians

Practice addresses (Care Compare)

24420 Ford Rd
Dearborn Heights, MI 48127-3233
Phone (313) 925-3304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC CurrentSince Nov 17, 2014 Accepting new patients
Associated Surgical Center of Dearborn LLC CurrentSince Nov 1, 2024 Accepting new patients
Associated Surgical Center of Dearborn LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

24420 Ford Rd
Dearborn Heights, MI 48127
Phone (313) 202-9400

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

1000 W University Dr
Ste 100
Rochester, MI 48307
Phone (248) 402-0266

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1275574063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 522",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARJANOVIC",
        "first_name": "MILOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": "4301075660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.