Individual provider Active NPI

Jelena Pavlovic, M.D.

  • Neurology Physician
  • Bronx, NY
National Provider Identifier
1972863801
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
60 262642 Issued in NY
Practice address
1575 Blondell Ave
Suite 225
Bronx, NY 10461-2660
Phone
(718) 405-8360
Fax
(718) 405-8369
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 60 262642 NY Primary

Addresses

Primary practice location

1575 Blondell Ave
Suite 225
Bronx, NY 10461-2660

Mailing address

1575 Blondell Ave
Suite 225
Bronx, NY 10461-2660
Phone (718) 405-8360

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
I20120913000246 NY Practitioner - Neurology 1759539976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Pennsylvania State University College of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60 262642NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Past Accepting new patients

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1972863801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 BLONDELL AVE",
            "address_2": "SUITE 225",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612660",
            "telephone_number": "718-405-8360",
            "fax_number": "718-405-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BLONDELL AVE",
            "address_2": "SUITE 225",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612660",
            "telephone_number": "718-405-8360",
            "fax_number": "718-405-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOVIC",
        "first_name": "JELENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "60 262642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.