Individual provider Active NPI

Jelena Nikolic, MD

  • Hospitalist Physician
  • Alton, IL
National Provider Identifier
1689174682
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036156526 Issued in IL
Practice address
1 Memorial Dr
Alton, IL 62002-6722
Phone
(618) 463-7240
NPI assigned
Feb 15, 2018
Last updated
Sep 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036156526 IL
Hospitalist Physician 208M00000X 036156526 IL Primary

Addresses

Primary practice location

1 Memorial Dr
Alton, IL 62002-6722

Mailing address

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

Other practice location 1

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (312) 567-2000 ext. 2053

Other names 1

  • Jelena Atlagic Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813000016 IL Practitioner - Hospitalist 5991109985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Sep 1, 2021 Accepting new patients
Fairview Heights Medical Group SC Current Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1689174682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162315",
            "country_code": "US",
            "telephone_number": "312-567-2000 x2053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKOLIC",
        "first_name": "JELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036156526",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036156526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Memorial Dr",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JELENA",
            "last_name": "ATLAGIC",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.