Individual provider Active NPI

Brittany E Radke, O.D.

  • Optometrist
  • Oakdale, MN
National Provider Identifier
1780022210
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3548 Issued in MN
Practice address
7011 10TH St N
Oakdale, MN 55128-5938
Phone
(651) 768-8040
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3308-35 WI
Optometrist 152W00000X 3548 MN Primary

Addresses

Primary practice location

7011 10TH St N
Oakdale, MN 55128-5938

Mailing address

PO Box 171
Saint Michael, MN 55376-0171
Phone (855) 324-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 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

Enrollment IDStateProvider typePAC IDDetails
I20131017001685 WI Practitioner - Optometry 6204060635 Reassigns benefits to 1 organization
I20180329001125 MN Practitioner - Optometry 6204060635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Care Prescott, LTD.Group PAC ID 8224397260, 5 clinicians
Premier Eye Care, Cottage Grove, LTDGroup PAC ID 5395756407, 4 clinicians

Practice addresses (Care Compare)

1435 N Acres Rd
Suite 700
Prescott, WI 54021-7053
Phone (715) 262-1020

6936 Pine Arbor Dr S
Suite 110
Cottage Grove, MN 55016-4645
Phone (651) 769-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3548MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eye Care, Cottage Grove, LTD Optometrist CurrentSince Mar 14, 2022 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince Mar 10, 2021 Accepting new patients

Locations

7430 80th St S
Ste 103
Cottage Grove, MN 55016
Phone (651) 459-9000

6936 Pine Arbor Dr S
Ste 110
Cottage Grove, MN 55016
Phone (651) 769-1020

740 Main St
Mendota Heights, MN 55118
Phone (651) 686-9393

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

7011 10th St N
Saint Paul, MN 55128
Phone (651) 738-8040

2070 Eagle Creek Ln
Ste 200
Woodbury, MN 55129
Phone (651) 436-3356

1435 N Acres Rd
Ste 700
Prescott, WI 54021
Phone (715) 262-1010

Organizations & group practices 4

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1780022210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553760171",
            "telephone_number": "855-324-3330",
            "fax_number": "855-324-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 10TH ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285938",
            "telephone_number": "651-768-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "BRITTANY",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3308-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, MN

Sources for this page

Verify at the official NPI Registry.