Individual provider Active NPI

Ana Radovic-Stakic, M.D.

  • Pediatric Adolescent Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1457514994
Registry record updated Jan 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD442386 Issued in PA
Practice address
120 Lytton Ave
Pittsburgh, PA 15213-1481
Phone
(412) 692-6677
Fax
(412) 692-8584
NPI assigned
Jul 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT193209 PA
Pediatric Adolescent Medicine Physician 2080A0000X MD442386 PA Primary

Addresses

Primary practice location

120 Lytton Ave
Pittsburgh, PA 15213-1481

Mailing address

120 Lytton Ave
Pittsburgh, PA 15213-1481
Phone (412) 692-6677

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ana.radovicstakic@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141106001034 PA Practitioner - Pediatric Medicine 8729200712 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193209PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Sep 7, 2014 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Pediatrics CurrentSince Sep 7, 2014 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

3420 5th Ave
Pittsburgh, PA 15213
Phone (412) 692-5285

120 Lytton Ave
Ste M60
Pittsburgh, PA 15213
Phone (412) 621-6540

120 Lytton Ave
Pittsburgh, PA 15213
Phone (412) 647-9494

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1457514994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LYTTON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131481",
            "telephone_number": "412-692-6677",
            "fax_number": "412-692-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LYTTON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131481",
            "telephone_number": "412-692-6677",
            "fax_number": "412-692-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOVIC-STAKIC",
        "first_name": "ANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-04",
        "last_updated": "2022-01-02",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT193209",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD442386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ana.radovicstakic@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.