Theresa Radtke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

270A00667600 Issued in NJ

Practice address

1053 Bloomfield Ave
Clifton, NJ 07012-2120

Phone

(973) 594-0020

Fax

(973) 594-0120

NPI assigned

Jul 6, 2016

Last updated

Apr 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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.

Enrollment records 2

Specialty

Optometry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theresa Radtke OD LLCGroup PAC ID 1759650138, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Theresa Radtke, OD LLC

  dba InSight Eye and Vision Care

  • Optometrist
  • Clifton, NJ
  • NPI 1255851887
  Medicare reassignment Care Compare group Authorized official
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD
• Morillo Eye Care

  • Optometrist
  • Clifton, NJ
  • NPI 1235488727
  NPD (past)

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1659723310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122120",
            "telephone_number": "973-594-0020",
            "fax_number": "973-594-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122120",
            "telephone_number": "973-594-0020",
            "fax_number": "973-594-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADTKE",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008483",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00667600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.