Bradley Dennis Raetzke, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35.094950 Issued in OH

Practice address

1654 Upham Dr
167 Means Hall
Columbus, OH 43210-1250

Phone

(614) 293-3551

Fax

(614) 293-3124

NPI assigned

Jul 21, 2008

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

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Mid-Ohio Emergency Services, LLC

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1386691780
  Medicare reassignment

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1841455797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 UPHAM DR",
            "address_2": "167 MEANS HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-3551",
            "fax_number": "614-293-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 UPHAM DR",
            "address_2": "167 MEANS HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-3551",
            "fax_number": "614-293-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAETZKE",
        "first_name": "BRADLEY",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.094950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzana Radovanovic, LPN
• Steven M. Radwany, MD
• Emily Rady
• Nibras Rady, RN
• Kellie Lyn Rae, LISW
• Julia Raffa, QMHS BA CMS
• Amber Raffeld, MFTT BA
• Kirsten Markiea Rafiq
• Mussarat Rafiq, CNP
• Imran Rafique, MD

• Emergency Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.