Individual provider Active NPI

Tracy L Radke, OT

  • Occupational Therapist
  • Weston, WI
National Provider Identifier
1659489458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1340 Issued in WI
Practice address
3402 Howland Ave
Suite 100
Weston, WI 54476-5633
Phone
(715) 355-5701
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1340 WI Primary

Addresses

Primary practice location

3402 Howland Ave
Suite 100
Weston, WI 54476-5633

Mailing address

3000 Westhill Dr
Suite 303
Wausau, WI 54401-3795

Other identifiers 1

IdentifierTypeStateIssuer
40832900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000258 WI Practitioner - Occupational Therapist in Private Practice 7810941648 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1340WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince May 1, 2019 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 14, 2022 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince May 1, 2019 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 14, 2022 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince May 1, 2019 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince May 1, 2019 Accepting new patients
Aspirus Wausau Hospital Inc Past Accepting new patients
Aspirus Medical Group, Inc. Past Accepting new patients
Aspirus Medical Group, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

3200 Westhill Dr
Ste 100
Wausau, WI 54401
Phone (715) 843-1058

3402 Howland Ave
Ste 100
Weston, WI 54476
Phone (715) 355-5701

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Organizations & group practices 12

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659489458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DR",
            "address_2": "SUITE 303",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 HOWLAND AVE",
            "address_2": "SUITE 100",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765633",
            "telephone_number": "715-355-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40832900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.