NPIMap

Organization Active NPI

Dr Miodrag Zivic LLC

  • Internal Medicine Physician
  • Beachwood, OH
National Provider Identifier
1437557782
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR MIODRAG ZIVIC LLC
Practice address
25200 Chagrin Blvd Ste 300
Beachwood, OH 44122-5684
Phone
(216) 383-2834
Fax
(216) 383-2923
NPI assigned
Dec 18, 2014
Last updated
May 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Dr. Miodrag V. Zivic, MDNPI 1225011836
Title
MD/Owner
Phone
(216) 383-2834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

25200 Chagrin Blvd Ste 300
Beachwood, OH 44122-5684

Mailing address

25200 Chagrin Blvd Ste 300
Beachwood, OH 44122-5684
Phone (216) 383-2834

Other practice location 1

99 Northline Cir Ste 215
Euclid, OH 44119-1481
Phone (216) 383-2834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150224000173 OH Part B Supplier - Clinic/Group Practice 9739405457 Receives reassigned benefits from 16 practitioners
Practice locations: Beachwood, OH; Euclid, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2126007Dr Miodrag Zivic, LLC99 Northline Circle, Suite 215, Euclid, OH 44119Certificate of waiverFeb 16, 2027
36D2131926Dr Miodrag Zivic, LLC25200 Chagrin Blvd, Suite 300, Beachwood, OH 44122Certificate of waiverJun 7, 2027

National Provider Directory

National Provider Directory

Locations

25200 Chagrin Blvd
Ste 300
Cleveland, OH 44122
Phone (216) 383-2834

9901 Johnnycake Ridge Rd
Mentor, OH 44060
Phone (216) 633-7576

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1437557782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25200 CHAGRIN BLVD STE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225684",
            "telephone_number": "216-383-2834",
            "fax_number": "216-383-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CHAGRIN BLVD STE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225684",
            "telephone_number": "216-383-2834",
            "fax_number": "216-383-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Northline Cir Ste 215",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441191481",
            "country_code": "US",
            "telephone_number": "216-383-2834",
            "fax_number": "216-342-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR MIODRAG ZIVIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "ZIVIC",
        "authorized_official_first_name": "MIODRAG",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "216-383-2834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.