Jelena Vasic, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA11091500 Issued in NJ

Practice address

1 Seymour St
Montclair, NJ 07042-3771

Phone

(973) 302-9585

Fax

(908) 790-6500

NPI assigned

Mar 5, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Dermatology

Education

Northwestern University Feinberg Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Spring Street Dermatology, PLLCGroup PAC ID 7113305517, 11 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Spring Street Dermatology, PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1639408818

  NY

  Medicare reassignment Care Compare group NPD
• Schweiger Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1831438662
  Care Compare group
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • Norwalk, CT
  • NPI 1851132831
  NPD (past)

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1851784532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SEYMOUR ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423771",
            "telephone_number": "973-302-9585",
            "fax_number": "908-790-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASIC",
        "first_name": "JELENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11091500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Van Raalte, PSY.D
• Deborah Diane Vaphides, ACUPUNCTURIST
• Nora Lee Vargas
• Narciza Varzovaite
• Shuba Vasan, BCBA
• Gregoria Vasquez, M.D.
• James Anthony Vasquez, RPH
• Christina Vassallo, APN
• Raymond Vazquez
• Johnathan Peter Velardi

• All providers in Montclair, NJ
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.