Individual provider Active NPI

Brian Lightwine, D.O.

  • Pediatric Radiology Physician
  • Tucson, AZ
National Provider Identifier
1154856508
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
010337 Issued in AZ
Practice address
1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone
(520) 694-4034
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 010337 AZ Primary

Addresses

Primary practice location

1625 N Campbell Ave
Tucson, AZ 85719-4330

Mailing address

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-4034

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
I20230804002569 AZ Practitioner - Diagnostic Radiology 9335498047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10337AZMDPharmacist
010337AZMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Banner-University Medical Group CurrentSince Aug 1, 2023 Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

2901 N Central Ave
Phoenix, AZ 85012
Phone (520) 874-1090

1625 N Campbell Ave
Tucson, AZ 85719

707 N Alvernon Way
Ste 201
Tucson, AZ 85711
Phone (520) 694-1725

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

4291 N Campbell Ave
Tucson, AZ 85719
Phone (520) 425-8900

265 W Ina Rd
Tucson, AZ 85704
Phone (520) 694-8000

2800 E Ajo Way
Bldg 200
Tucson, AZ 85713
Phone (520) 874-2000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Tucson, AZ 85719
Phone (520) 694-2873

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1154856508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTWINE",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "AZ",
            "license": "010337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.