Russell David Radtke, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME108856 Issued in FL

Practice address

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Phone

(813) 870-4000

NPI assigned

May 15, 2007

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 3

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emergency Medical Associates of Tampa Bay, LLC

  dba Excelis Medical Associates

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1023397817
  Medicare reassignment NPD
• Observation Medical Group LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1952763682
  Medicare reassignment NPD
• Tampa Bay Emergency Physicians LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1114977428
  Medicare reassignment NPD
• Tampa Bay Emergency Physicians-Heartland LLC

  • Emergency Medicine Physician
  • Sebring, FL
  • NPI 1043661408
  Medicare reassignment NPD
• Observation Medical Group LLC

  • Emergency Medicine Physician
  • Riverview, FL
  • NPI 1467094425
  NPD

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1841406071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10030",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321200030",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-870-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADTKE",
        "first_name": "RUSSELL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME108856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BC/BS",
            "identifier": "148MW",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002280200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DG472Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Radiology Associates of Tampa PA
• Radiology of MSMC, LLC
• Radley L Griffin MD PL
• Katelyn Michelle Radner, DMD
• Lorena Yao Radney, APRN
• Tyler Radziszewski, OTD
• Rafael a Rondon MD PA
• Rafael Matos Medical Center Inc
• Raisa I Rafalovich, ARNP
• Ramish Hussain Rafay, MD

• Emergency Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.