NPIMap

Individual provider Active NPI

Michelle Marie Radtke, APNP, FNP

  • Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1821687385
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10664-33 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 454-5007
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10664-33 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

130 2ND St
Neenah, WI 54956-2883
Phone (920) 454-5007

Other practice location 1

9368 Blanco Rd
Winneconne, WI 54986-9546
Phone (920) 585-1699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511002231 WI Practitioner - Nurse Practitioner 1658780218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Surgical Associates LTDGroup PAC ID 7911971296, 35 clinicians

Practice addresses (Care Compare)

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone (920) 731-8131

Hospital & facility affiliations

  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince May 15, 2021 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
Fox Valley Surgical Associates LTD CurrentSince Apr 14, 2025 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

2500 E Capitol Dr
Ste 1700
Appleton, WI 54911
Phone (920) 734-9600

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

2000 E Milestone Dr
Appleton, WI 54913
Phone (920) 358-1729

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

200 Theda Clark Medical Plz
Ste 320
Neenah, WI 54956
Phone (920) 722-3341

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

130 2nd St
Ste 197
Neenah, WI 54956
Phone (920) 729-2030

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: mradtke307716@direct.thedacare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1821687385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-454-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-454-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9368 Blanco Rd",
            "address_purpose": "LOCATION",
            "city": "Winneconne",
            "state": "WI",
            "postal_code": "549869546",
            "country_code": "US",
            "telephone_number": "920-585-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADTKE",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "APNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10664-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.