Individual provider Active NPI

Ivan Velickovic, M.D.

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1891789160
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
249250 Issued in NY
Practice address
451 Clarkson Ave
Brooklyn, NY 11203-2054
Phone
(718) 245-3325
Fax
(718) 245-3054
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 249250 NY Primary

Addresses

Primary practice location

451 Clarkson Ave
Brooklyn, NY 11203-2054

Mailing address

333 Cedar St Dept of
New Haven, CT 06510-3206

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050921000212 NY Practitioner - AnesthesiologyPractitioner - Other (Physician) 3971537812 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249250NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 1, 2005 Accepting new patients
University Physicians of Brooklyn, Inc Anesthesiology CurrentSince Jul 1, 2005 Accepting new patients
Yale University Anesthesiology Current Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

333 Cedar St
New Haven, CT 06510
Phone (203) 432-4771

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1891789160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST DEPT OF",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032054",
            "telephone_number": "718-245-3325",
            "fax_number": "718-245-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELICKOVIC",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "249250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.