Individual provider Active NPI

Ivana Popovic

  • Family Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1760196562
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704326676NSA24004 Issued in MI
Practice address
1200 E Michigan Ave Ste 340
Lansing, MI 48912-1894
Phone
(517) 364-5931
NPI assigned
Jan 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 4704326676NSA24004 MI Primary

Addresses

Primary practice location

1200 E Michigan Ave Ste 340
Lansing, MI 48912-1894

Mailing address

303 E Kearsley St
Flint, MI 48502-1907

Other practice location 1

303 E Kearsley St
Flint, MI 48502-1907
Phone (810) 762-3300

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
I20241226000225 MI Practitioner - Nurse Practitioner 8820525223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
Suite 340 University of Michigan Health SP
Lansing, MI 48912-1894
Phone (517) 364-5930

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704326676NSA24004MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Oct 13, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 13, 2024 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1200 E Michigan Ave
Ste 340
Lansing, MI 48912
Phone (517) 364-5930

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 4

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 2

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": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1760196562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 340",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121894",
            "telephone_number": "517-364-5931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Kearsley St",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485021907",
            "country_code": "US",
            "telephone_number": "810-762-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPOVIC",
        "first_name": "IVANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704326676NSA24004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.