Active NPI
Laura L Radke, MD
- Infectious Disease Physician
- Waukesha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 31373
- Practice address
- N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates
Waukesha, WI 53188-1135 - Phone
- (262) 574-8000
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 31373 | WI | |
| Infectious Disease Physician | 207RI0200X | 31373 | WI | Primary |
Addresses
Primary practice location
N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates
Waukesha, WI 53188-1135
Mailing address
N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates
Waukesha, WI 53188-1135
Phone (262) 574-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31870200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31373 | WI | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Internal Medicine | Current | Accepting new patients |
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616
2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
20611 Watertown Rd
Ste J
Waukesha, WI 53186
Phone (262) 782-0000
N14W23833 Stone Ridge Dr
Ste 240
Waukesha, WI 53188
Phone (262) 232-8777
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533
Interoperability endpoints
- lradkemd241360@direct.froedtert.com
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326067200000",
"number": "1265516645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N14W23900 STONE RIDGE DR",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531881135",
"telephone_number": "262-574-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N14W23900 STONE RIDGE DR",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531881135",
"telephone_number": "262-574-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADKE",
"first_name": "LAURA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2012-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "31373",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "WI",
"license": "31373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31870200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.