Individual provider Active NPI

Miljan Cukic

  • Physical Therapy Assistant
  • Lutherville, MD
National Provider Identifier
1679810253
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A3795 Issued in MD
Practice address
515 Brightfield Rd
Lutherville, MD 21093-3643
Phone
(410) 718-5916
NPI assigned
Jan 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A3795 MD Primary

Addresses

Primary practice location

515 Brightfield Rd
Lutherville, MD 21093-3643

Mailing address

515 Brightfield Rd
Lutherville, MD 21093-3643
Phone (410) 718-5916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A3795MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1679810253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BRIGHTFIELD RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210933643",
            "telephone_number": "410-718-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BRIGHTFIELD RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210933643",
            "telephone_number": "410-718-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUKIC",
        "first_name": "MILJAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.