Active NPI
Ida Jivotovski
- Pediatric Nurse Practitioner
- Stamford, CT
National Provider Identifier
1477229144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 9884
- Practice address
- 1200 High Ridge Rd Ste 3
Stamford, CT 06905-1202 - Phone
- (465) 813-2176
- NPI assigned
- Aug 21, 2021
- Last updated
- Nov 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 9884 | CT | Primary |
Addresses
Primary practice location
1200 High Ridge Rd Ste 3
Stamford, CT 06905-1202
Mailing address
51 Dennis LN
Pleasantville, NY 10570-1032
Phone (631) 316-4553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Pediatric Urology Associates of New Jersey, PC | Past | Accepting new patients |
Locations
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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.
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- NPI 1285826438
CT, NY
-
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- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Specialist
- Englewood, NJ
- NPI 1013295245
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1477229144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 DENNIS LN",
"city": "PLEASANTVILLE",
"state": "NY",
"postal_code": "105701032",
"telephone_number": "631-316-4553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HIGH RIDGE RD STE 3",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069051202",
"telephone_number": "465-813-2176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIVOTOVSKI",
"first_name": "IDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-21",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "9884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.