Active NPI
Gary A Podolny, MD
- Diagnostic Radiology Physician
- Tucson, AZ
National Provider Identifier
1003812272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35209
- Practice address
- 13305 E Saddlerock Rd
Tucson, AZ 85749-9296 - Phone
- (520) 749-3468
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35209 | AZ | Primary |
| Diagnostic Ultrasound Physician | 2085U0001X | 35209 | AZ | |
| Body Imaging Physician | 2085B0100X | 35209 | AZ |
Addresses
Primary practice location
13305 E Saddlerock Rd
Tucson, AZ 85749-9296
Mailing address
13305 E Saddlerock Rd
Tucson, AZ 85749-9296
Phone (520) 749-3468
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003812272 | Other | AZ | PHYSICIAN INDIVIDUAL NPI |
| 005472 | Other | AZ | GROUP MEDICAID ID |
| 133383 | Medicaid | AZ | |
| 1841261989 | Other | AZ | GROUP NPI |
| CS7943 | Other | AZ | GROUP MEDICARE RAILROAD ID & PTAN |
| ZWCBBM | Other | AZ | GROUP MEDICARE ID |
| P00358695 | Other | AZ | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35209 | AZ | MD | Body Imaging Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366848000000",
"number": "1003812272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13305 E SADDLEROCK RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857499296",
"telephone_number": "520-749-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13305 E SADDLEROCK RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857499296",
"telephone_number": "520-749-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODOLNY",
"first_name": "GARY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2013-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "35209",
"primary": true
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "AZ",
"license": "35209",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "AZ",
"license": "35209",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN INDIVIDUAL NPI",
"identifier": "1003812272",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID ID",
"identifier": "005472",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133383",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1841261989",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE RAILROAD ID & PTAN",
"identifier": "CS7943",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE ID",
"identifier": "ZWCBBM",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00358695",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.