Individual provider Active NPI

Stefan W Radke, MA

  • Case Manager/Care Coordinator
  • Auburn Hills, MI
National Provider Identifier
1508449463
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
171M00000X Issued in MI
Practice address
2399 E Walton Blvd
Auburn Hills, MI 48326-1955
Phone
(586) 864-2135
NPI assigned
Apr 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 171M00000X MI Primary

Addresses

Primary practice location

2399 E Walton Blvd
Auburn Hills, MI 48326-1955

Mailing address

2399 E Walton Blvd
Auburn Hills, MI 48326-1955
Phone (586) 864-2135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002001525 MI Practitioner - Mental Health Counselor 8224534813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Oakland Univ, William Beaumont School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15600 19 Mile Rd
Clinton Township, MI 48038-3502

2399 E Walton Blvd
Auburn Hills, MI 48326-1955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
171M00000XMIMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1508449463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 E WALTON BLVD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483261955",
            "telephone_number": "586-864-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 E WALTON BLVD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483261955",
            "telephone_number": "586-864-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "STEFAN",
        "middle_name": "W",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "171M00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

Verify at the official NPI Registry.