Nicholas A. Radetzky, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

4372 Issued in NY

Practice address

3582 Broadway
New York, NY 10031-3201

Phone

(212) 234-2020

Fax

(212) 234-4609

NPI assigned

Jan 18, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

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 and National Provider Directory roles.

• Broadway Vision Center Inc.

  • Optometrist
  • New York, NY
  • NPI 1982704862
  Medicare reassignment Authorized official
• Vistasite Hamilton Corp

  • Optometrist
  • New York, NY
  • NPI 1063210052
  NPD
• Glassman Eye LLC

  • Health Service Clinic/Center
  • Brooklyn, NY
  • NPI 1750717963
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1710967682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3582 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313201",
            "telephone_number": "212-234-2020",
            "fax_number": "212-234-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3582 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313201",
            "telephone_number": "212-234-2020",
            "fax_number": "212-234-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADETZKY",
        "first_name": "NICHOLAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "4372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01033870",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie A. Radel, LCSW
• Gianna Marie Radeljic, MD, MPP
• Emily Smith Rademacher
• Jurgen Rademaker, MD
• Stephanie Laura Michele Rademeyer, MD
• Elise Radford, M.S., CCC-SLP
• Aditya Radhakrishnan, M.D.
• Jai Radhakrishnan, M.D.
• Jolly Radhakrishnan, MD
• Farhan Radhanpuri, PT

• Corneal and Contact Management Optometrist in New York, NY
• Providers in New York, NY by specialty
• Corneal and Contact Management Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.