Individual provider Active NPI

Emily A Radtke, NP

  • Gerontology Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1467951160
Registry record updated Nov 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11017360 Issued in FL
Practice address
111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone
(888) 731-8994
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704322326 MI
Gerontology Nurse Practitioner 363LG0600X APRN11017360 FL Primary

Addresses

Primary practice location

111 N Orange Ave Ste 800
Orlando, FL 32801-2381

Mailing address

111 N Orange Ave Ste 800
Orlando, FL 32801-2381

Other practice location 1

699 S Indiana Ave
Englewood, FL 34223-3705
Phone (941) 477-4007

Other practice location 2

400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1599
Phone (888) 731-8994

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
I20220126002327 FL Practitioner - Nurse Practitioner 8426482043 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bliss Dermatology LLCGroup PAC ID 9335594316, 5 clinicians

Practice addresses (Care Compare)

315 Nokomis Ave S
Venice, FL 34285-2417
Phone (941) 477-4007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.76
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss Dermatology, LLC CurrentSince Jan 6, 2025 Accepting new patients
Rejuva Dermatology & Vein Center, PLLC CurrentSince Feb 1, 2024 Accepting new patients
Johnson Medical Center of Venice, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 24, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 24, 2022 Accepting new patients
Interact of Michigan, Inc PastSince Aug 13, 2019 Accepting new patients
Personal Wellness Medicine, LLC PastSince Feb 7, 2021 Accepting new patients

Locations

699 S Indiana Ave
Englewood, FL 34223
Phone (941) 474-8811

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

421 Commercial Ct
Ste A
Venice, FL 34292
Phone (941) 484-3557

315 Nokomis Ave S
Venice, FL 34285
Phone (941) 477-4007

1287 US Highway 41 Byp S
Venice, FL 34285
Phone (941) 202-0500

395 Commercial Ct
Ste C
Venice, FL 34292
Phone (941) 529-0070

2389 E Venice Ave
Venice, FL 34292

401 Johnson Ln
Ste 101
Venice, FL 34285
Phone (813) 484-5333

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762646400000",
    "number": "1467951160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "699 S Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "FL",
            "postal_code": "342233705",
            "country_code": "US",
            "telephone_number": "941-477-4007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Renaissance Ctr Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482431599",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADTKE",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2025-11-09",
        "certification_date": "2025-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704322326",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11017360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.