Mary Ellen Radosevich, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP3727 Issued in AZ

Practice address

4375 E Irma LN
Phoenix, AZ 85050-4312

Phone

(480) 890-5800

NPI assigned

Dec 27, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment Care Compare group NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1417238908
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD
• Banner Occupational Health Arizona LLC

  • Occupational Medicine Clinic/Center
  • Phoenix, AZ
  • NPI 1144572611
  NPD (past)
• Banner Occupational Health Arizona LLC

  • Occupational Medicine Clinic/Center
  • Glendale, AZ
  • NPI 1649813445
  NPD (past)
• Banner Occupational Health Arizona LLC

  • Occupational Medicine Clinic/Center
  • Phoenix, AZ
  • NPI 1811530611
  NPD (past)
• South County Fire & Medical District

  • Land Ambulance
  • Sun Lakes, AZ
  • NPI 1740276690
  NPD (past)

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742083200000",
    "number": "1245534726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOSEVICH",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3727",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kris George Radke, M.C., M.A.T.
• Louis Michael Radnothy, D.O.
• Geoffrey Peter Radoff, MD
• Patricia Radomski
• John Radosevich, PHARM.D.
• Arthur B Radow, M.D.
• Brandy Radtke
• Ioan Radu
• Maria Radulovic, NP
• Nadine L Radway, PA-C

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.