Justin Radaker, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT025851 Issued in PA

Practice address

18 Sportsman Dr Ste 10
Clarion, PA 16214-8572

Phone

(814) 226-1356

Fax

(814) 226-1240

NPI assigned

May 11, 2017

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

Enrolled in WY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Physical Therapy LLCGroup PAC ID 0345242178, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Excel Physical Therapy, LLC

  • Physical Therapist
  • Jackson, WY
  • NPI 1356414684
  Medicare reassignment Care Compare group NPD
• Phoenix Rehabilitation and Health Services, Inc.

  • Physical Therapist
  • Clarion, PA
  • NPI 1659711737
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1679009609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SPORTSMAN DR STE 10",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148572",
            "telephone_number": "814-226-1356",
            "fax_number": "814-226-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SPORTSMAN DR STE 10",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148572",
            "telephone_number": "814-226-1356",
            "fax_number": "814-226-1240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1294 E Main St",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162141212",
            "country_code": "US",
            "telephone_number": "814-297-8093",
            "fax_number": "814-297-8176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "499 Mayfield Road",
            "address_2": "Office 134",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "16214",
            "country_code": "US",
            "telephone_number": "814-226-1356",
            "fax_number": "814-226-1240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADAKER",
        "first_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra K Potter, NCC, MA
• Primary Health Network
• Primary Health Network
• Primary Health Network
• Jennifer A Pusateri, LPC
• Thomas Edward Radecki, M.D.
• Chad Andrew Rankin, MS, ATC
• Johnna Danae Rapp
• Leah Marron Rapp
• Kristin Lee Raybuck, LPN

• Physical Therapist in Clarion, PA
• Providers in Clarion, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.