Staci Jo Radtke, APNP - Medicare Nurse Practitioner in New London, WI

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Staci Jo Radtke, APNP is a medicare enrolled "Nurse Practitioner" in New London, Wisconsin. Her current practice location is 1405 Mill St, New London, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 531-2400.

Staci Jo Radtke is licensed to practice in Wisconsin (license number 4264-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558662254.

Contact Information

Staci Jo Radtke, APNP
1405 Mill St,
New London, WI 54961-2155
(920) 531-2400
(920) 531-2466

Map and Direction




Provider's Profile

Full NameStaci Jo Radtke
GenderFemale
SpecialityNurse Practitioner
Location1405 Mill St, New London, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1558662254
  • Provider Enumeration Date: 11/11/2010
  • Last Update Date: 11/27/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9234312257
  • Enrollment ID: I20110328000823

Medical Identifiers

Medical identifiers for Staci Jo Radtke such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558662254NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 4264 (Wisconsin)Secondary
363L00000XNurse Practitioner 4264-33 (Wisconsin)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Staci Jo Radtke allows following entities to bill medicare on her behalf.
Entity NameThedacare, Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376656959
PECOS PAC ID: 1759294887
Enrollment ID: O20031106000088
Entity NameMarshfield Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952347981
PECOS PAC ID: 2264345206
Enrollment ID: O20031106000590
Entity NameThedacare Medical Center - Shawano, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548260839
PECOS PAC ID: 5890605836
Enrollment ID: O20031117000117
Entity NameThedacare Medical Center - Berlin, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760413777
PECOS PAC ID: 0446151666
Enrollment ID: O20040120000214
Entity NameThedacare Medical Center - New London, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538127220
PECOS PAC ID: 5698664480
Enrollment ID: O20040311000254
Entity NameThedacare Medical Center - Waupaca, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780782680
PECOS PAC ID: 3072504216
Enrollment ID: O20040524000645
Entity NameThedacare Medical Center - Wild Rose, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043263999
PECOS PAC ID: 6507840923
Enrollment ID: O20040615000235
Entity NameMchs Hospitals Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093221434
PECOS PAC ID: 5698071173
Enrollment ID: O20180208000096

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Staci Jo Radtke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Staci Jo Radtke, APNP
3 Neenah Ctr,
Neenah, WI 54956-3070

Ph: (715) 526-7308		Staci Jo Radtke, APNP
1405 Mill St,
New London, WI 54961-2155

Ph: (920) 531-2400

Reviews and Comments


Nurse Practitioner Nurses in New London, WI

Natalie G Gauthier, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2400    
Allsion R Stache, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-831-5050    Fax: 920-531-2207
Jennifer Schaffer, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2400    
Tori C Beyer, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2398    
Cara Benner, APNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2400    
Herbert A Nolan, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2400    
Kimberly R Brown, APNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1405 Mill St, New London, WI 54961
Phone: 920-531-2400    Fax: 920-531-2463

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.