Individual provider Active NPI

Mahija Vucetovic, RN, FNP, BSN, MSN

  • Family Nurse Practitioner
  • Astoria, NY
National Provider Identifier
1558665802
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335461 Issued in NY
Practice address
4502 Ditmars Blvd Apt 120
Astoria, NY 11105-1328
Phone
(347) 339-9092
NPI assigned
Dec 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335461 NY Primary

Addresses

Primary practice location

4502 Ditmars Blvd Apt 120
Astoria, NY 11105-1328

Mailing address

4502 Ditmars Blvd Apt 120
Astoria, NY 11105-1328
Phone (347) 339-9092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180516002578 NY Practitioner - Nurse Practitioner 4284998477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1558665802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 DITMARS BLVD APT 120",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051328",
            "telephone_number": "347-339-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 DITMARS BLVD APT 120",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051328",
            "telephone_number": "347-339-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUCETOVIC",
        "first_name": "MAHIJA",
        "name_prefix": "Ms.",
        "credential": "RN, FNP, BSN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.