Srdjan Prodanovich, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME95851 Issued in FL

Practice address

90 Cypress Way E
Suite 50
Naples, FL 34110-9275

Phone

(239) 598-3200

Fax

(239) 598-0233

NPI assigned

May 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Dermatology

Education

University of Miami, LM Miller School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as individual

Quality

72.63

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dermatologic & Cosmetic Institute Inc

  • Dermatology Physician
  • Naples, FL
  • NPI 1639125735
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1871540377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CYPRESS WAY E",
            "address_2": "SUITE 50",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341109275",
            "telephone_number": "239-598-3200",
            "fax_number": "239-598-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CYPRESS WAY E",
            "address_2": "SUITE 50",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341109275",
            "telephone_number": "239-598-3200",
            "fax_number": "239-598-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRODANOVICH",
        "first_name": "SRDJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME95851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00423914",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7613852",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276398200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "53224",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Pritchard
• Privatus Care Solutions, Inc.
• PRN Home Inc
• Pro-Adjuster Chiropractic Clinic Inc (Naples Spine Institute)
• Jeffrey Procopio, PA-C
• Ana Proenza, MD
• Nilda Proenza, CASE MANAGER
• Raul Proenza, MD
• Progressive First Assistants, LLC
• Progressive Medical USA

• Dermatology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.