Individual provider Active NPI

Mirjana Cesnjaj, MD

  • Family Medicine Physician
  • Urbana, IL
National Provider Identifier
1750553814
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036119881 Issued in IL
Practice address
1818 E. Windsor Road
Family Medicine/Convenient Care
Urbana, IL 61802
Phone
(217) 255-9670
Fax
(217) 255-9650
NPI assigned
Mar 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036119881 IL Primary
Family Medicine Physician 207Q00000X 036.119881 IL

Addresses

Primary practice location

1818 E. Windsor Road
Family Medicine/Convenient Care
Urbana, IL 61802

Mailing address

P.O. Box 6002
Urbana, IL 61803-6002
Phone (217) 326-8300

Other identifiers 1

IdentifierTypeStateIssuer
0533210001OtherDMERC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016001124 IL Order and Referring Only - Family PracticePractitioner - Family Practice 7315005576

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.119881ILMDFamily Medicine Physician
036119881ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1750553814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E. WINDSOR ROAD",
            "address_2": "FAMILY MEDICINE/CONVENIENT CARE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61802",
            "telephone_number": "217-255-9670",
            "fax_number": "217-255-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CESNJAJ",
        "first_name": "MIRJANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-29",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119881",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.119881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.