NPIMap

Individual provider Active NPI

Davorka Vucetic, M.D.

  • Pulmonary Disease Physician
  • Menomonee Falls, WI
National Provider Identifier
1487819496
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
67747 Issued in WI
Practice address
W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone
(262) 253-5400
NPI assigned
Jul 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301092566 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301092566 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 67747 WI
Pulmonary Disease Physician 207RP1001X 4301092566 MI
Pulmonary Disease Physician 207RP1001X 67747 WI Primary

Addresses

Primary practice location

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538

Mailing address

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Other practice location 1

1560 E Maple Rd
Suite 400 - Credentialing Department
Troy, MI 48083-1138
Phone (313) 745-4525

Other identifiers 1

IdentifierTypeStateIssuer
1487819496MedicaidWI

Other names 1

  • Dr. Davorka Nikolic Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170914004153 WI Practitioner - Pulmonary Disease 4587710769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67747WIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 24, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Jul 24, 2017 Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: dnikolicmd218285@direct.froedtert.com
  • Direct secure messaging: dnikolic14111@direct.hfhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1487819496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 E Maple Rd",
            "address_2": "Suite 400 - Credentialing Department",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480831138",
            "country_code": "US",
            "telephone_number": "313-745-4525",
            "fax_number": "313-993-0085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VUCETIC",
        "first_name": "DAVORKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-20",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092566",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301092566",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "67747",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301092566",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "67747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487819496",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVORKA",
            "last_name": "NIKOLIC",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.