Individual provider Active NPI

Jovana Obradovic, M.D.

  • Emergency Medicine Physician
  • Orlando, FL
National Provider Identifier
1992157796
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME139313 Issued in FL
Practice address
1414 Kuhl Ave # MP31
Orlando, FL 32806-2008
Phone
(407) 237-6329
Fax
(407) 649-3083
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN23494 FL
Emergency Medicine Physician 207P00000X ME139313 FL Primary

Addresses

Primary practice location

1414 Kuhl Ave # MP31
Orlando, FL 32806-2008

Mailing address

1414 Kuhl Ave # MP31
Orlando, FL 32806-2008
Phone (407) 237-6329

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190823002162 FL Practitioner - Emergency Medicine 2365770633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Emergency Medicine of Broward LLCGroup PAC ID 5991793002, 69 clinicians

Practice addresses (Care Compare)

3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone (954) 939-5000

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME139313FLMDUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Nov 5, 2019 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Nov 5, 2019 Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

5565 Centerview Dr
Ste 107
Raleigh, NC 27606
Phone (213) 484-7111

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1992157796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 KUHL AVE # MP31",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "407-237-6329",
            "fax_number": "407-649-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 KUHL AVE # MP31",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "407-237-6329",
            "fax_number": "407-649-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRADOVIC",
        "first_name": "JOVANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN23494",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME139313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.