Active NPI
Joseph Radich, PA-C
- Physician Assistant
- West Palm Beach, FL
National Provider Identifier
1932452158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9106969
- Practice address
- 2513 S Dixie Hwy
West Palm Beach, FL 33401-7917 - Phone
- (561) 331-2983
- NPI assigned
- Oct 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.008904 | IL | |
| Physician Assistant | 363A00000X | PA59144 | CA | |
| Physician Assistant | 363A00000X | 001012360 | NC | |
| Medical Physician Assistant | 363AM0700X | 016134-1 | NY | |
| Physician Assistant | 363A00000X | 9106969 | FL | Primary |
Addresses
Primary practice location
2513 S Dixie Hwy
West Palm Beach, FL 33401-7917
Mailing address
636 Fern St
West Palm Beach, FL 33401-5712
Phone (845) 863-4400
Other practice location 1
1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421
Phone (561) 331-2983
Other practice location 2
11903 Southern Blvd
Suite 208
Royal Palm Beach, FL 33411-7644
Phone (561) 784-7852
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141113001572 | FL | Order and Referring Only - Physician Assistant | 9032331756 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA59144 | CA | MD | Physician Assistant |
| 9106969 | FL | MD | Physician Assistant |
| 085.008904 | IL | MD | Physician Assistant |
| 001012360 | NC | MD | Physician Assistant |
| 016134-1 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R3 Health LLC | Physician Assistant | Current | Accepting new patients |
| Renewu | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Dr. Sears Center for Health and Wellness, Inc. | Past | Accepting new patients |
Locations
1411 N Flagler Dr
Ste 9000
West Palm Beach, FL 33401
Phone (561) 584-8460
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.
-
- Physician Assistant
- West Palm Beach, FL
- NPI 1245818327
-
- Medical Specialty Clinic/Center
- West Palm Beach, FL
- NPI 1942821699
-
- Clinic/Center
- Royal Palm Beach, FL
- NPI 1598099830
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1932452158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 FERN ST",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334015712",
"telephone_number": "845-863-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2513 S DIXIE HWY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334017917",
"telephone_number": "561-331-2983"
}
],
"practiceLocations": [
{
"address_1": "1411 N Flagler Dr Ste 9000",
"address_purpose": "LOCATION",
"city": "West Palm Beach",
"state": "FL",
"postal_code": "334013421",
"country_code": "US",
"telephone_number": "561-331-2983",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11903 Southern Blvd",
"address_2": "Suite 208",
"address_purpose": "LOCATION",
"city": "Royal Palm Beach",
"state": "FL",
"postal_code": "334117644",
"country_code": "US",
"telephone_number": "561-784-7852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RADICH",
"first_name": "JOSEPH",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-25",
"last_updated": "2022-12-20",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.008904",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA59144",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001012360",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "016134-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9106969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.