Active NPI
Ivan Bandovic, DO
- Orthopaedic Surgery Physician
- Albany, NY
National Provider Identifier
1912526773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 337402
- Practice address
- 121 Everett Rd
Albany, NY 12205-1474 - Phone
- (518) 489-2663
- Fax
- (518) 689-3910
- NPI assigned
- Apr 13, 2020
- Last updated
- Jul 21, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthopaedic Surgery Physician | 207X00000X | 337402 | NY | Primary |
Addresses
Primary practice location
121 Everett Rd
Albany, NY 12205-1474
Mailing address
121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663
Other practice location 1
22101 Moross Rd Ste 214
Detroit, MI 48236-2148
Phone (313) 343-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200706000698 | MI | Order and Referring Only - Orthopedic Surgery | 0749603066 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337402 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedicsny, LLP | Current | Accepting new patients | |
| Orthopedicsny, LLP | Orthopaedic Surgery | Past | Accepting new patients |
Locations
121 Everett Rd
Colonie, NY 12205
1768 Route 9
Halfmoon, NY 12065
Organizations & group practices 2
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.
-
- Specialist
- Albany, NY
- NPI 1568415412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1912526773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 EVERETT RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051474",
"telephone_number": "518-489-2663",
"fax_number": "518-689-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 EVERETT RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051474",
"telephone_number": "518-489-2663",
"fax_number": "518-689-3910"
}
],
"practiceLocations": [
{
"address_1": "22101 Moross Rd Ste 214",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482362148",
"country_code": "US",
"telephone_number": "313-343-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANDOVIC",
"first_name": "IVAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-13",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "337402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.