Individual provider Active NPI

Alexandra Leigh Raderstorf, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1225803083
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11029673 Issued in FL
Practice address
10881 San Jose Blvd
Jacksonville, FL 32223-6612
Phone
(904) 880-5522
Fax
(904) 880-5533
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11029673 FL Primary

Addresses

Primary practice location

10881 San Jose Blvd
Jacksonville, FL 32223-6612

Mailing address

10881 San Jose Blvd
Jacksonville, FL 32223-6612
Phone (904) 880-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20231218000195 FL Practitioner - Nurse Practitioner 3072962984 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11029673FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ackerman Cancer Center, PA CurrentSince Nov 27, 2023 Accepting new patients
Ackerman Cancer Center, PA CurrentSince Nov 27, 2023 Accepting new patients

Locations

10881 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 260-3022

Organizations & group practices 2

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1225803083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10881 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236612",
            "telephone_number": "904-880-5522",
            "fax_number": "904-880-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10881 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236612",
            "telephone_number": "904-880-5522",
            "fax_number": "904-880-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADERSTORF",
        "first_name": "ALEXANDRA",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11029673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.