Thomas E Radosevich, M.D.
Individual provider Active NPI Family Medicine Physician · Thermopolis, WY
NPI 1114969698 · NPPES record last updated Aug 29, 2019
Key facts
- NPI
- 1114969698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5976A (WY)
- Practice address
- 120 N C Ave
Thermopolis, WY 82443-2410 - Phone
- (307) 864-5534
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Creighton University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- S48Wy1 LLC
Practice addresses (Care Compare)
231 S Wilson St
Casper, WY 82601-2941
Phone (307) 265-3791
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100210000680 | WY | Practitioner - Family Practice | 1557404746 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wyoming | Family Medicine | Current | Accepting new patients |
| Hot Springs County Hospital District | Current |
Accepting new patients | |
| S48Wy1, LLC | Current |
Accepting new patients | |
| Hot Springs County Hospital District | Current |
Accepting new patients | |
| Family Medical Center | Current |
Accepting new patients | |
| Sound Physicians of Wyoming, LLC | Family Medicine | Current |
Accepting new patients |
| University of Wyoming | Family Medicine | Current |
Accepting new patients |
| Wyoming Recovery Rawlins | Current |
Accepting new patients | |
| University of Wyoming | Family Medicine | Past | Accepting new patients |
Locations
497 W Lott St
Buffalo, WY 82834
Phone (307) 684-2228
1522 E A St
Casper, WY 82601
Phone (307) 233-6000
231 S Wilson St
Casper, WY 82601
Phone (307) 265-3791
1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171
820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055
120 N C Ave
Thermopolis, WY 82443
Phone (307) 864-5534
150 E Arapahoe St
Thermopolis, WY 82443
Phone (307) 864-3121
1125 Charles Ave
Worland, WY 82401
Phone (307) 347-2449
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5976A | WY | Yes |
Addresses
Primary practice location
120 N C Ave
Thermopolis, WY 82443-2410
Mailing address
231 S Wilson St
Casper, WY 82601-2941
Phone (307) 234-6161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117895400 | Medicaid | WY |
Other providers in Thermopolis, WY
- Christopher H Paris
- Physical Therapy Clinic PC
- Leif Andrew Polson
- Roger Pomeroy
- Leila H Porath
- Michael J Rawlings
- Red Rock Family Practice, Inc
- Red Rock Family Practice, PC
- William Dwight Robinson
- Kevin James Ryan
All providers in Thermopolis, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.