Active NPI
Thaddeus F Radziwiecki, D.P.M.
- Podiatrist
- Highland, IN
National Provider Identifier
1346277597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 07000594A
- Practice address
- 3641 Ridge Rd
Suite 6
Highland, IN 46322-2080 - Phone
- (219) 838-4000
- Fax
- (219) 838-4387
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07000594A | IN | Primary |
Addresses
Primary practice location
3641 Ridge Rd
Suite 6
Highland, IN 46322-2080
Mailing address
3641 Ridge Rd
Suite 6
Highland, IN 46322-2080
Phone (219) 838-4000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480026572 | Other | RAILROAD MEDICARE | |
| 000000080130 | Other | IN | ANTHEM BLUE CROSS SHIELD |
| 5622190001 | Other | IN | MEDICARE DMEPOS |
Other names 1
- Dr. Ted Radziwiecki
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07000594A | IN | MD | Podiatrist |
Interoperability endpoints
- tradziwiecki63980@direct.franciscanalliance.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262217600000",
"number": "1346277597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3641 RIDGE RD",
"address_2": "SUITE 6",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463222080",
"telephone_number": "219-838-4000",
"fax_number": "219-838-4387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3641 RIDGE RD",
"address_2": "SUITE 6",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463222080",
"telephone_number": "219-838-4000",
"fax_number": "219-838-4387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADZIWIECKI",
"first_name": "THADDEUS",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2009-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "07000594A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480026572",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS SHIELD",
"identifier": "000000080130",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DMEPOS",
"identifier": "5622190001",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TED",
"last_name": "RADZIWIECKI",
"prefix": "DR.",
"credential": "D.P.M.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Highland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.