Active NPI
Brankica Stanisic, MD
- Psychiatry Physician
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036166331
- Practice address
- 5001 Hardy St
Hattiesburg, MS 39402-1308 - Phone
- (601) 296-3963
- NPI assigned
- Mar 21, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 036166331 | IL | Primary |
Addresses
Primary practice location
5001 Hardy St
Hattiesburg, MS 39402-1308
Mailing address
5701 N Sheridan Rd Apt 8P
Chicago, IL 60660-4797
Phone (239) 595-0624
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231127001704 | IL | Practitioner - Psychiatry | 2860815495 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
1701 E College Ave
Bloomington, IL 61704-2101
Phone (309) 664-3130
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000
2200 Fort Jesse Rd
Ste 220
Normal, IL 61761
Phone (309) 664-3130
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 1
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": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1659831014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 N SHERIDAN RD APT 8P",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606604797",
"telephone_number": "239-595-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 HARDY ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021308",
"telephone_number": "601-296-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANISIC",
"first_name": "BRANKICA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-21",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036166331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.