Thomas John Radic, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL19060 Issued in CO

Practice address

696 Daniel Webster Hwy
Merrimack, NH 03054-2748

Phone

(603) 429-8427

Fax

(603) 429-1756

NPI assigned

Jun 7, 2023

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Luna Care Physical Therapy LLCGroup PAC ID 7517363617, 210 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Colorado Luna Care Physical Therapy LLC

  • Physical Therapist
  • Denver, CO
  • NPI 1891461125
  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment NPD
• Intermountain Medical Group Denver, LLC

  dba Orthopedic Centers of Colorado - Saint Joseph

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  dba Intermountain Health Heart & Vascular - Wheat Ridge Clinic

  • Cardiovascular Disease Physician
  • Wheat Ridge, CO
  • NPI 1437768124
  NPD

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1184318669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 LUTZ RUN RD",
            "city": "ROSTRAVER TOWNSHIP",
            "state": "PA",
            "postal_code": "150123849",
            "telephone_number": "724-889-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 DANIEL WEBSTER HWY",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030542748",
            "telephone_number": "603-429-8427",
            "fax_number": "603-429-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADIC",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4970",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL19060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Connecticut Medical PC (Fidelity Health & Wellness Center)
• Premise Health of Connecticut Medical, P.C. (BAE Systems Merrimack NH)
• Michael Richard Procaccini, OD
• Tara J Pucci, DPT
• Quest Diagnostics Incorporated
• Arturo Ramirez Fernandez, MS, PSYD
• Annmarie Henson Reebenacker, M.ED.
• Venetia Constantine Reilly, PT
• Reliable Respiratory, Inc.
• Jessica Repetto

• Physical Therapist in Merrimack, NH
• Providers in Merrimack, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.