Individual provider Active NPI

Ethan Radzinsky

  • Diagnostic Radiology Physician
  • San Jose, CA
National Provider Identifier
1114555430
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
177745 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5110
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 177745 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250807003277 CA Practitioner - Diagnostic Radiology 2466950605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

1640 E Roseville Pkwy
Suite 9
Roseville, CA 95661-3902
Phone (916) 784-2277

1651 Exposition Blvd
Sacramento, CA 95815-5149
Phone (916) 731-7770

16911 Willow Glen Rd
Brownsville, CA 95919-9707
Phone (530) 675-2457

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

250 W Main St
Woodland, CA 95695-3652
Phone (916) 668-6100

2660 W Covell Blvd
Davis, CA 95616-5645
Phone (530) 747-3000

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

3200 Bell Rd
Auburn, CA 95603-9244
Phone (530) 885-7616

3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone (916) 851-1440

3301 C St
Suite 1500
Sacramento, CA 95816-3371
Phone (877) 827-7463

440 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3409

444 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3420

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

4868 X St
Sacramento, CA 95817-2205

550 W Ranch View Dr
Suite 1200
Rocklin, CA 95765-5398
Phone (916) 295-5810

7551 Madison Ave
Citrus Heights, CA 95610-7449
Phone (916) 904-3000

8110 Laguna Blvd
Elk Grove, CA 95758-8094
Phone (916) 683-3942

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177745CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4860 Y St
Ste 500
Sacramento, CA 95817
Phone (916) 734-3171

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

Interoperability endpoints

  • Direct secure messaging: eradzinsky625225@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1114555430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZINSKY",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "177745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.