DJORDJE MILIVOJEVIC (DO) – Family Medicine Physician, NPI 1225612674

DJORDJE MILIVOJEVIC (DO) is a healthcare provider. based in Colton, California. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 20A21186 (CA). The NPI Number for DJORDJE MILIVOJEVIC (DO) is 1225612674

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DJORDJE MILIVOJEVIC (DO)
NPI
1225612674
Phone
(909) 580-1000
Address
400 N PEPPER AVE
Enumeration Date
11 May 2021
Last Update Date
23 February 2025

Doctor Profile

Medical School Name
COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Secondary Phone
9095801000
Graduation Year
2021 (5 years ago)
PAC ID
2668879321
Group Practice PAC ID
2668812710
Professional Enrollment ID
I20240103003066
Address ID
CA923241801CO400XXAVEX400
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

13,194 FAMILY PRACTICE in CA

Provider Addresses for DJORDJE MILIVOJEVIC (DO)

  • 400 N PEPPER AVE

    COLTON, CA 923241819

    Phone: (909) 580-1000

    Type: Mailing

  • 1499 E HIGHLAND AVE

    SAN BERNARDINO, CA 924044611

    Phone: (855) 422-8029

    Type: Location

  • 1509 WILSON TER

    GLENDALE, CA 912064007

    Phone: (858) 531-6829

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $142.

Total Amount is formed as General ($142) + Research ($0) + Ownership ($0) = $142.

Last reported payment date: 2024-07-23 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($58).

Total Amount

$142

General + Research + Ownership

Payments

6

Total payment records

General Amount

$142

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240103003066IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92324)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668812710View full group profile
NameSpecialtyState
Nurse PractitionerCA
Family PracticeCA
Nurse PractitionerCA
Physician AssistantCA
Family PracticeCA
Family PracticeCA
Family PracticeTX
Family PracticeCA
Nurse PractitionerCA
Family PracticeCA

Reviews

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Frequently asked questions

Is DJORDJE MILIVOJEVIC (DO) listed with a National Provider Identifier?
Yes — DJORDJE MILIVOJEVIC (DO) has NPI 1225612674 on file in the registry.
Would DJORDJE MILIVOJEVIC (DO) appear as active to a payer?
You can treat DJORDJE MILIVOJEVIC (DO) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DJORDJE MILIVOJEVIC (DO)?
DJORDJE MILIVOJEVIC (DO)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with DJORDJE MILIVOJEVIC (DO)?
Directory geography for DJORDJE MILIVOJEVIC (DO) centers on Colton, California.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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