Joseph J Radakovich, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D6195 Issued in OR

Practice address

5050 NE Hoyt St
Suite 322
Portland, OR 97213

Phone

(503) 230-0322

Fax

(503) 230-0344

NPI assigned

Jul 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 1, 2016 through Mar 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Head & Neck Surgical Associates, PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Portland, OR
  • NPI 1821153941
  NPD (past)
• Portland Oral and Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Portland, OR
  • NPI 1659238038
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689698466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 322",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97213",
            "telephone_number": "503-230-0322",
            "fax_number": "503-230-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 322",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97213",
            "telephone_number": "503-230-0322",
            "fax_number": "503-230-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADAKOVICH",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D6195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "931090894",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Rackovan
• Rachel Rackow, M.D.
• Shira Racoosin
• Darlasue Rada-Quillen
• Ladan Radafshar
• Carla Christine Radcliffe, MD
• Jack Radcliffe
• Michele Raddish, MD
• Melissa Anne Radecki, M.D.
• Patrick Louis Radecki, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Portland, OR
• Providers in Portland, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• 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; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.