Ljubisa Micic, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

212787 Issued in NY

Practice address

2604 169TH St
Flushing, NY 11358-1131

Phone

(347) 438-1950

Fax

(347) 438-1951

NPI assigned

Jul 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Nephrology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Medical Care PLLCGroup PAC ID 3274842224, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CRD Associates LLC Cliffside Nursing Home Dialysis facility, Flushing, NY, CCN 332650
• Rogosin Auburndale Dialysis Dialysis facility, Flushing, NY, CCN 332680
• DaVita Van Wyck Dialysis Dialysis facility, Jamaica, NY, CCN 332509
• DaVita Clearview Dialysis Dialysis facility, Bayside, NY, CCN 332787
• Flushing Hospital Medical Center Hospital, Flushing, NY, CCN 330193

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Nephrology Medical Care PLLC

  • Specialist
  • Flushing, NY
  • NPI 1306222526
  Medicare reassignment Care Compare group
• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1548217763
  Medicare reassignment NPD
• Flushing Hospital Medical Center

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1568693174
  NPD
• Mattoo & Bhat Medical Associates, P.C.

  • Specialist
  • Ridgewood, NY
  • NPI 1215978267
  NPD (past)

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

• Cliffside Nursing Home Inc

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1699978452

  Dialysis facility

  Care Compare affiliation Name & address match
• Knickerbocker Dialysis Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bayside, NY
  • NPI 1710404108

  Dialysis facility

  Care Compare affiliation Name & address match
• Knickerbocker Dialysis Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jamaica, NY
  • NPI 1942792239

  Dialysis facility

  Care Compare affiliation Name & address match
• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1154461622
  Care Compare affiliation
• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1548217763
  Care Compare affiliation

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1750395000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 169TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581131",
            "telephone_number": "347-438-1950",
            "fax_number": "347-438-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 169TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581131",
            "telephone_number": "347-438-1950",
            "fax_number": "347-438-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICIC",
        "first_name": "LJUBISA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "212787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01894586",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bonnie L Migden, M.A., CCC-SLP
• Mikhail Medical PLLC
• Mikhail Yakubov, D.O., PLLC
• Ashraf Mikhail, M.D.

• Nephrology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.