Individual provider Active NPI

Vinkica Vucemilovic, MD

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1801890868
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME77878 Issued in FL
Practice address
6560 9TH Ave N
St Petersburg, FL 33710-6216
Phone
(727) 384-4060
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME77878 FL Primary

Addresses

Primary practice location

6560 9TH Ave N
St Petersburg, FL 33710-6216

Mailing address

PO Box 2832
Lakeland, FL 33806-2832
Phone (727) 384-4060

Other identifiers 1

IdentifierTypeStateIssuer
300434100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040913000520 FL Practitioner - Family Practice 4789651548 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME77878FLMDFamily Medicine Physician

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Sunset Medical Care, LLC Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Palms of Pasadena Emergency Physicians LLC Past Accepting new patients
David a Long MD, PA PastSince Aug 1, 2004 Accepting new patients

Locations

6560 9th Ave N
St Petersburg, FL 33710
Phone (727) 384-4060

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1801890868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2832",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338062832",
            "telephone_number": "727-384-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 9TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337106216",
            "telephone_number": "727-384-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUCEMILOVIC",
        "first_name": "VINKICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME77878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300434100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.