Individual provider Active NPI

Scott Thomas Radomsky, M.D.

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1033102843
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24164 Issued in AZ
Practice address
105 S Houghton Rd Ste 101
Tucson, AZ 85748-6732
Phone
(520) 438-5449
Fax
(520) 457-5692
NPI assigned
Aug 26, 2005
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24164 AZ Primary

Addresses

Primary practice location

105 S Houghton Rd Ste 101
Tucson, AZ 85748-6732

Mailing address

105 S Houghton Rd Ste 101
Tucson, AZ 85748-6732
Phone (520) 438-5449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429003712 AZ Practitioner - Pediatric Medicine 7618493990 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24164AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roadrunner Pediatrics Pediatrics CurrentSince Apr 1, 2025 Accepting new patients
Tanque Verde Pediatrics, P.C. Pediatrics Past Accepting new patients

Locations

105 S Houghton Rd
Ste 101
Tucson, AZ 85748
Phone (520) 324-4403

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1033102843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S HOUGHTON RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486732",
            "telephone_number": "520-438-5449",
            "fax_number": "520-457-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S HOUGHTON RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486732",
            "telephone_number": "520-438-5449",
            "fax_number": "520-457-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOMSKY",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "24164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.