IVANA MITIC CRNA
NPI 1962743815
Nurse Practitioner - Psychiatric/Mental Health in Sparks, MD
About Ivana Mitic Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IVANA MITIC CRNA (NPI 1962743815) is an individual psychiatric/mental health provider in Sparks, Maryland, licensed in Maryland (R212937) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with Northwest Hospital Center, and maintains a secondary practice location in Salisbury.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ivana Mitic Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Ivana Mitic reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Sparks Glencoe, MD 21152
- Reassigned Medicare billing, Maryland enrollment
- 4 clinicians in this Medicare group
Randallstown, MD 21133
- Reassigned Medicare billing, Maryland enrollment
- 135 clinicians in this Medicare group
Irving, TX 75038
- Reassigned Medicare billing, Florida enrollment
- 85 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northwest Hospital Center
Acute Care Hospitals · Randallstown, MDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21152 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SPARKS, MD 21152
SPARKS GLENCOE, MD 21152
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ivana Mitic's NPI number?
The NPI number for Ivana Mitic is 1962743815. It was assigned to this individual provider in the NPPES registry on March 1, 2013.
Where is Ivana Mitic located?
Ivana Mitic practices at 909 Ridgebrook Rd Ste 202, Sparks, MD 21152. The listed phone number is (410) 870-5482.
What is Ivana Mitic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Ivana Mitic enrolled in Medicare?
Yes. Ivana Mitic is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Ivana Mitic's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ivana Mitic reassigns Medicare benefits to 3 organizations: Baltimore Ketamine Clinic (Sparks Glencoe, MD), Lifebridge Anesthesia Associates, LLC (Randallstown, MD) and Northstar Anesthesia Of Florida LLC (Irving, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ivana Mitic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Ivana Mitic affiliated with any hospitals?
According to CMS data, Ivana Mitic is affiliated with Northwest Hospital Center.
When was this NPI record last updated?
The NPPES record for Ivana Mitic was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ivana Mitic, CRNA · NPI 1962743815
Psychiatric/Mental Health physician in Sparks, Maryland. Individual provider, active in the CMS NPPES registry since March 1, 2013.
## Identity
- **NPI:** 1962743815 (Entity type: Individual)
- **Enumerated:** March 1, 2013
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R212937 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 909 RIDGEBROOK RD STE 202, Sparks, MD 21152-9476
- **Phone:** (410) 870-5482
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Baltimore Ketamine Clinic (NPI 1972145381, Sparks Glencoe, MD); Lifebridge Anesthesia Associates, LLC (NPI 1003992868, Randallstown, MD); Northstar Anesthesia Of Florida LLC (NPI 1568056166, Irving, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** April 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1962743815) · Data from the CMS NPPES public registry.