Active NPI
Mirjana Rudic
- Hearing Instrument Specialist
- Bellevue, WA
National Provider Identifier
1992179865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HA 60437694
- Practice address
- 208 Bellevue Way NE
Bellevue, WA 98004-5720 - Phone
- (425) 455-5596
- Fax
- (425) 451-3248
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HA 60437694 | WA | Primary |
Addresses
Primary practice location
208 Bellevue Way NE
Bellevue, WA 98004-5720
Mailing address
PO Box 350
Maple Valley, WA 98038-0350
Phone (425) 358-0956
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2049826 | Medicaid | WA |
Other names 1
- Mirjana Radivojevic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HA 60437694 | WA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473811200000",
"number": "1992179865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 350",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980380350",
"telephone_number": "425-358-0956",
"fax_number": "877-481-6931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 BELLEVUE WAY NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980045720",
"telephone_number": "425-455-5596",
"fax_number": "425-451-3248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDIC",
"first_name": "MIRJANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2016-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WA",
"license": "HA 60437694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2049826",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MIRJANA",
"last_name": "RADIVOJEVIC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.