Kenneth Francis Raderstorf III, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28222082A Issued in IN

Practice address

3301 County Road 6 E
Elkhart, IN 46514-7673

Phone

(574) 266-5342

Fax

(574) 266-5847

NPI assigned

May 19, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Indiana Medical College, School of Medicine of Purdue University, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kraderstorf1219346@direct.trinity-health.org

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.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group NPD
• Elite Emergency Physicians Inc

  • Emergency Medicine Physician
  • Elkhart, IN
  • NPI 1932155371
  Medicare reassignment NPD
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Bone and Joint Specialists

  • Critical Care Medicine (Internal Medicine) Physician
  • Elkhart, IN
  • NPI 1821222829
  NPD
• Beacon Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1831149525
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Memorial Epworth Center

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Beacon Granger Hospital, A Memorial Hospital Extension

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1023682416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "547-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 COUNTY ROAD 6 E",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465147673",
            "telephone_number": "574-266-5342",
            "fax_number": "574-266-5847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-243-4306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-1082",
            "fax_number": "574-875-3860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1753 Fulton St",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465141927",
            "country_code": "US",
            "telephone_number": "574-293-9448",
            "fax_number": "574-293-9480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 W Warren St",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "IN",
            "postal_code": "465409410",
            "country_code": "US",
            "telephone_number": "574-358-0042",
            "fax_number": "574-358-0157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-874-1200",
            "fax_number": "574-875-0362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 E Ireland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-1750",
            "fax_number": "574-647-1748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADERSTORF",
        "first_name": "KENNETH",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28222082A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300065926",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaley B Puzynski, PA-C
• Saadia Qasim, M.D.
• Mark A. Quiring, M.D.
• Shana Quirk
• Timothy Alan Quist, D.P.M.
• Johna Ann Radford, FNP-BC
• Fnu Rafaqat, MD
• Hoda Rahmani, MD
• Sunderaj Rajkumar, PT
• Harmanpreet Bobby Rakhra, M.D.

• Family Nurse Practitioner in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.