NPIMap

Individual provider Active NPI

Srdjan S Nedeljkovic, MD

  • Anesthesiology Physician
  • Brighton, MA
National Provider Identifier
1457347015
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
60559 Issued in MA
Practice address
736 Cambridge St
Dept of Anesthesiology CMP2
Brighton, MA 02135-2907
Phone
(617) 789-2777
Fax
(617) 234-6384
NPI assigned
Sep 20, 2005
Last updated
Dec 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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 60559 MA Primary

Addresses

Primary practice location

736 Cambridge St
Dept of Anesthesiology CMP2
Brighton, MA 02135-2907

Mailing address

736 Cambridge St
Dept of Anesthesiology CMP2
Brighton, MA 02135-2907
Phone (617) 789-2777

Other identifiers 2

IdentifierTypeStateIssuer
30205027MedicaidNH
3015512MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421000492 MA Practitioner - AnesthesiologyPractitioner - Pain Management 1254379084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Jefferson Medical College of Thomas Jefferson University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

850 Boylston St
Chestnut Hill, MA 02467-2477
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Anesthesiology CurrentSince May 30, 2015 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Atrius Health, Inc. CurrentSince Apr 23, 1992 Accepting new patients
Atrius Health, Inc. CurrentSince Apr 23, 1992 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients
Steward Medical Group, Inc Past Accepting new patients
Capa Anesthesia LLC Anesthesiology Past Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

45 Francis St
Boston, MA 02115
Phone (617) 332-1700

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

850 Boylston St
Chestnut Hill, MA 02467
Phone (617) 732-5773

850 Boylston St
Ste 402
Chestnut Hill, MA 02467
Phone (617) 732-9300

Interoperability endpoints

  • Direct secure messaging: nedeljkovic.srdjan.bwh@direct.partners.masshiway.net
  • Direct secure messaging: snedeljkovicmd8477@direct.atrius.masshiway.net

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 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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1457347015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "DEPT OF ANESTHESIOLOGY CMP2",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2777",
            "fax_number": "617-234-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "DEPT OF ANESTHESIOLOGY CMP2",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2777",
            "fax_number": "617-234-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELJKOVIC",
        "first_name": "SRDJAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "60559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30205027",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3015512",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.