DR. IVAN MARK PAVKOVIC M.D. NPI 1528060068

NPI Information

NPI: 1528060068
Provider Name: DR. IVAN MARK PAVKOVIC, M.D.
Classification: Pediatrics - 2080P0008X
Entity Type: Individual

Specialization: Neurodevelopmental Disabilities

PECOS Registration: Yes

Address:
410 LAKEVILLE RD
SUITE 105
NEW HYDE PARK, NY
ZIP 11042
Phone: (516) 465-5255
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DR. Ivan Mark Pavkovic, M.D. is a neurodevelopmental disabilities pediatrics in New Hyde Park, NY. The provider is a pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. DR. Ivan Mark Pavkovic, M.D. NPI is 1528060068. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

410 LAKEVILLE RD
SUITE 105
NEW HYDE PARK, NY
ZIP 11042-101
Phone: (516) 465-5255

The NPI 1528060068 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 4/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		19840	NEBRASKA	No
2	2080P0008X	Pediatrics	Neurodevelopmental Disabilities	2008-01446	NORTH CAROLINA	No
3	2080P0008X	Pediatrics	Neurodevelopmental Disabilities	282145	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	F29831	MEDICARE UPIN	NEBRASKA
2	04056	OTHER	NEBRASKA	BLUE CROSS BLUE SHIELD NE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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