Individual provider Active NPI

Radmila Mihailovski Simovski

  • Acute Care Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1700449857
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704283236 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(800) 653-6568
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
Yes

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0000X 4704283236 MI
Nurse Practitioner 363L00000X 4704283236 MI
Acute Care Nurse Practitioner 363LA2100X 4704283236 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

798 Snyder St
Oxford, MI 48371-6327

Other practice location 1

798 Snyder St
Oxford, MI 48371-6327
Phone (586) 212-1917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20201106000235 MI Practitioner - Nurse Practitioner 0749690543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704283236MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Maplegrove Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rsimovski536457@direct.hfhs.org

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 and National Provider Directory roles.

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1700449857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 SNYDER ST",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "800-653-6568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "798 Snyder St",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MI",
            "postal_code": "483716327",
            "country_code": "US",
            "telephone_number": "586-212-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMOVSKI",
        "first_name": "RADMILA",
        "middle_name": "MIHAILOVSKI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": "MI",
            "license": "4704283236",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704283236",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704283236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.