Boris Miokovic, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036169455 Issued in IL

Practice address

3333 N Seminary St
Galesburg, IL 61401-1251

Phone

(309) 343-5114

NPI assigned

May 19, 2021

Reactivated

Feb 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Holy Family Medical Center Hospital, Monmouth, IL, CCN 141318
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  • Critical Access Hospital
  • Monmouth, IL
  • NPI 1548393184
  Care Compare affiliation
• Osf Healthcare System

  • Critical Access Hospital
  • Kewanee, IL
  • NPI 1871919381
  Care Compare affiliation
• St Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1609440148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PROSPECT ST., BUILDING 2 APT 2K",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "06850",
            "telephone_number": "347-656-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-343-5114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Maple St",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068503815",
            "country_code": "US",
            "telephone_number": "203-852-2025",
            "fax_number": "203-899-5224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIOKOVIC",
        "first_name": "BORIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "deactivation_date": "2022-11-03",
        "reactivation_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036169455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Orthopedic Services SC
• Midwest Orthopedic Services, SC
• Caleb W Milius, DO
• Marisa Susanne Miller
• Arnold John Minor, DDS
• Jennifer Mitchell, PHARMD
• Jerry E Mitchell, M.D.
• Kelly Mixon, APN
• Margaret Moore
• Patrick T. Moore, D.C.

• Internal Medicine Physician in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.
• 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.