Matthew Radkowski, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS035548 Issued in PA

Practice address

344 Budfield St
Suite 1
Johnstown, PA 15904-3214

Phone

(814) 262-0123

Fax

(814) 262-0516

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 31, 2016 through May 31, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Allegheny Orthodontic Associates

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Johnstown, PA
  • NPI 1912032806
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497880363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 BUDFIELD ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043214",
            "telephone_number": "814-262-0123",
            "fax_number": "814-262-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 BUDFIELD ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043214",
            "telephone_number": "814-262-0123",
            "fax_number": "814-262-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKOWSKI",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS035548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Areesha Qadir, MD
• Lian Qian, M.D.
• Quality Life Services - Westmont, LLC
• Muhammad Rehan Qureshi, MD
• Lindsey A Raco, LSW
• Olivia Paige Rager, LAPC, CAADC, NCC
• Fahad Rahman, MD
• Rebecca Marie Rakes
• Ralph Tabib MDPC
• Rachel Jennifer Ralph, MSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.