Richard F Radocha, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME37540 Issued in FL

Practice address

635 1St St N
Winter Haven, FL 33881-4129

Phone

(863) 294-0670

Fax

(863) 298-3200

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1992774855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814129",
            "telephone_number": "863-294-0670",
            "fax_number": "863-298-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814129",
            "telephone_number": "863-294-0670",
            "fax_number": "863-298-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOCHA",
        "first_name": "RICHARD",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME37540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045972100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID/ RRM PIN",
            "identifier": "110017782",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.