Individual
TODD A RADIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2007
NV
363AM0700X
Medical Physician Assistant
Primary
PA-C57
NV
363AM0700X
Medical Physician Assistant
Primary
PA2007
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497757181
SMA MEDICAID
NV
01
—
V110823
SMA MEDICARE
NV
Enumeration date
08/11/2005
Last updated
05/28/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up