Individual provider Active NPI

Miroslav Radulovic, MD

  • Internal Medicine Physician
  • Stamford, CT
National Provider Identifier
1770687428
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
046586 Issued in CT
Practice address
30 Shelburne Rd
Stamford, CT 06902-3628
Phone
(203) 276-7298
Fax
(203) 355-4842
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046586 CT Primary

Addresses

Primary practice location

30 Shelburne Rd
Stamford, CT 06902-3628

Mailing address

One Hospital Plaza
Stamford, CT 06904-9317
Phone (203) 276-7298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20081219000371 CT Practitioner - Hospitalist 7416019773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000

29 Hospital PLZ
Stamford, CT 06902-3602

4 Hospital PLZ
Suite 102
Stamford, CT 06902-3602
Phone (203) 276-2330

5 High Ridge Park
Suite 103
Stamford, CT 06905-1326
Phone (203) 276-4644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.86
Promoting interoperability
99
Improvement activities
40
Cost
71.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046586CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients

Locations

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mradulovic1945416@nychhc.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 1

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1770687428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL PLAZA",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069049317",
            "telephone_number": "203-276-7298",
            "fax_number": "203-276-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023628",
            "telephone_number": "203-276-7298",
            "fax_number": "203-355-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADULOVIC",
        "first_name": "MIROSLAV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "046586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.