Individual provider Active NPI

Anna Radisic, MD

  • Internal Medicine Physician
  • Lodi, NJ
National Provider Identifier
1013545862
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12521300 Issued in NJ
Practice address
160 Essex St Ste 102
Lodi, NJ 07644-2709
Phone
(551) 996-8111
Fax
(551) 996-8445
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME160304 FL
Internal Medicine Physician 207R00000X 25MA12521300 NJ Primary

Addresses

Primary practice location

160 Essex St Ste 102
Lodi, NJ 07644-2709

Mailing address

17 Davis Blvd Ste 308
Tampa, FL 33606-3438

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Other practice location 2

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 974-2201

Other identifiers 2

IdentifierTypeStateIssuer
118138600MedicaidFL
S4OQ7OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aradisic124126@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230627002257 FL Practitioner - Internal Medicine 5890153597
I20250722003845 NJ Practitioner - Internal Medicine 5890153597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

300 Perrine Rd
Suite 324
Old Bridge, NJ 08857-3628
Phone (732) 753-9890

985 Cedar Bridge Ave
Brick, NJ 08723-4167
Phone (732) 477-5600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Jul 11, 2025 Accepting new patients
Meridian Medical Group - Specialty Care, PC Internal Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

160 Essex St
Ste 102
Lodi, NJ 07644
Phone (551) 996-8111

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • Direct secure messaging: aradisic124126@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 3

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 2

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": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1013545862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ESSEX ST STE 102",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076442709",
            "telephone_number": "551-996-8111",
            "fax_number": "551-996-8445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Davis Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063438",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADISIC",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160304",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12521300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118138600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "S4OQ7",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aradisic124126@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lodi, NJ

Sources for this page

Verify at the official NPI Registry.