Theresa Radtke, OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00667600 Issued in NJ

Legal business name

THERESA RADTKE, OD LLC

Doing business as

InSight Eye and Vision Care

Practice address

1053 Bloomfield Ave
Clifton, NJ 07012-2120

Phone

(973) 594-0020

Fax

(973) 594-0120

NPI assigned

Jun 24, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Radtke, ODNPI 1659723310

Title

Owner/Optometrist

Phone

(201) 913-7808

Specialties & licenses 2

Addresses

Other names 1

• InSight Eye and Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Radtke, OD

  • Optometrist
  • Clifton, NJ
  • NPI 1659723310
  Medicare reassignment Care Compare group Authorized official
• Julianna Marie Mola, OD

  • Optometrist
  • Hawthorne, NJ
  • NPI 1740892280
  Medicare reassignment Care Compare group
• Diego Xavier Morillo, OD

  • Optometrist
  • Newark, NJ
  • NPI 1811059785
  NPD (past)

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1255851887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122120",
            "telephone_number": "973-594-0020",
            "fax_number": "973-594-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122120",
            "telephone_number": "973-594-0020",
            "fax_number": "973-594-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA RADTKE, OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-24",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "RADTKE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "201-913-7808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00667600",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InSight Eye and Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.