NPIMap

Individual provider Active NPI

Djordje Atanackovic, M.D.

  • Hematology (Internal Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1417384694
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
8702756-1252 Issued in UT
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 706-1946
NPI assigned
Oct 2, 2013
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 8702756-1252 UT Primary
Hematology & Oncology Physician 207RH0003X 8702756-1252 UT

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

203 Tunbridge Rd
Baltimore, MD 21212-3423
Phone (385) 242-8519

Other practice location 1

30 N 1900 E Rm 5C402
Salt Lake City, UT 84132-2706
Phone (801) 585-3229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140225001628 UT Practitioner - Hematology 5193955813 Reassigns benefits to 2 organizations
I20201008003362 MD Practitioner - Internal Medicine 5193955813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-1230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8702756-1252UTMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Specialty Services Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Specialty Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Maryland Oncology Associates, PA Hematology CurrentSince Aug 1, 2020 Accepting new patients
University of Maryland Oncology Associates, PA Hematology & Oncology CurrentSince Aug 1, 2020 Accepting new patients
University of Utah Specialty Services Hematology & Oncology CurrentSince Feb 1, 2015 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 8

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 1

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1417384694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 TUNBRIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123423",
            "telephone_number": "385-242-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-706-1946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E Rm 5C402",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841322706",
            "country_code": "US",
            "telephone_number": "801-585-3229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATANACKOVIC",
        "first_name": "DJORDJE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "UT",
            "license": "8702756-1252",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "UT",
            "license": "8702756-1252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.