Individual provider Active NPI

James Stephen Radke, MD

  • Gastroenterology Physician
  • Lighthouse Point, FL
National Provider Identifier
1518953025
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME154298 Issued in FL
Practice address
5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058
Phone
(954) 428-2480
Fax
(954) 428-2904
NPI assigned
Sep 21, 2005
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 33833 WI
Gastroenterology Physician 207RG0100X 036088439 IL
Gastroenterology Physician 207RG0100X ME154298 FL Primary

Addresses

Primary practice location

5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058

Mailing address

5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058
Phone (954) 428-2480

Other practice location 1

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-6148

Other practice location 2

1206 E 9th St Fl 3
Lockport, IL 60441-2404
Phone (630) 717-2600

Other identifiers 1

IdentifierTypeStateIssuer
32223900MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jradke222845@direct.edward.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215000410 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 0547323610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premium Practice Solutions, LLCGroup PAC ID 1456520949, 5 clinicians

Practice addresses (Care Compare)

5340 N Federal Hwy
Suite 110
Lighthouse Point, FL 33064-7058
Phone (954) 428-2480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as individual
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy69
Upper gastrointestinal (GI) endoscopy for acid reflux84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33833WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Practice Solutions, LLC Gastroenterology CurrentSince Nov 21, 2024 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
West Suburban Gastroenterology S C Gastroenterology Past Accepting new patients
Lighthouse Foot & Ankle Center PastSince Nov 21, 2024 Accepting new patients

Locations

1500 N University Dr
Ste 100
Coral Springs, FL 33071
Phone (954) 428-2480

5340 N Federal Hwy
Ste 110
Lighthouse Point, FL 33064
Phone (954) 358-4949

Interoperability endpoints

  • Direct secure messaging: jradke222845@direct.edward.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1518953025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY STE 110",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058",
            "telephone_number": "954-428-2480",
            "fax_number": "954-428-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY STE 110",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058",
            "telephone_number": "954-428-2480",
            "fax_number": "954-428-2904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 McHenry St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "WI",
            "postal_code": "531051828",
            "country_code": "US",
            "telephone_number": "262-767-6148",
            "fax_number": "262-767-6147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1206 E 9th St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Lockport",
            "state": "IL",
            "postal_code": "604412404",
            "country_code": "US",
            "telephone_number": "630-717-2600",
            "fax_number": "630-718-2656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADKE",
        "first_name": "JAMES",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "33833",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036088439",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME154298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32223900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jradke222845@direct.edward.org",
            "affiliation": "N",
            "address_1": "1206 E 9th St Fl 3",
            "city": "Lockport",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604412404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

Verify at the official NPI Registry.