NPIMap

Individual provider Active NPI

Slobodan Miseljic, MD

  • Diagnostic Radiology Physician
  • South Weymouth, MA
National Provider Identifier
1912985086
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
210026 Issued in MA
Practice address
55 Fogg Rd
South Weymouth, MA 02190-2432
Phone
(781) 337-7011
NPI assigned
Jan 9, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 210026 MA Primary

Addresses

Primary practice location

55 Fogg Rd
South Weymouth, MA 02190-2432

Mailing address

PO Box 1079
Lewiston, ME 04243-1079
Phone (800) 456-1552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000737 MA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 4082691183 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Radiology-Cra LLCGroup PAC ID 8426287269, 60 clinicians
MW Radiology-Cra LLCGroup PAC ID 6406270040, 40 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6240

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210026MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MW Radiology-Cra LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Oct 1, 2004 Accepting new patients
LGH Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Oct 16, 2017 Accepting new patients
Merrimack Radiology-Cra LLC Diagnostic Radiology CurrentSince Dec 3, 2017 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Oct 16, 2017 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Oct 16, 2017 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Oct 18, 2004 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Oct 1, 2004 Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology Past Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

354 Merrimack St
Lawrence, MA 01843
Phone (978) 688-3898

1 Hospital Dr
Lowell, MA 01852
Phone (978) 687-0156

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

Interoperability endpoints

  • Direct secure messaging: smiseljic31822@tuftsmedicine.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912985086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1079",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042431079",
            "telephone_number": "800-456-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-337-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISELJIC",
        "first_name": "SLOBODAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "210026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

Verify at the official NPI Registry.