Individual provider Active NPI

Jessica Eden Fazekas, D.O.

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1609938281
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
010710 Issued in AZ
Practice address
677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone
(520) 795-2889
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OS16388 FL
Diagnostic Radiology Physician 2085R0202X 240861-01 NY
Diagnostic Radiology Physician 2085R0202X 25MB08623000 NJ
Diagnostic Radiology Physician 2085R0202X 010710 AZ Primary

Addresses

Primary practice location

677 N Wilmot Rd
Tucson, AZ 85711-2701

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Other practice location 1

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080918000365 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1254415953 Reassigns benefits to 4 organizations
I20090817000594 NJ Practitioner - Diagnostic Radiology 1254415953 Reassigns benefits to 2 organizations
I20240321003363 NY Practitioner - Diagnostic Radiology 1254415953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rowan University School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology LTD LLCGroup PAC ID 6204727589, 107 clinicians
Nuvance Health Medical Practice PCGroup PAC ID 1658468442, 578 clinicians

Practice addresses (Care Compare)

Voorhees, NJ 08043
Phone (520) 795-2889

Voorhees, NJ 08043-3677
Phone (845) 431-4544

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
  • Benson Hospital Hospital, Benson, AZ, CCN 031301
  • Northern Cochise Community Hospital, Inc. Hospital, Willcox, AZ, CCN 031302
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
75.27
Improvement activities
40
Cost
74.3

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
010710AZMDDiagnostic Radiology Physician
OS16388FLMDDiagnostic Radiology Physician
25MB08623000NJMDDiagnostic Radiology Physician
240861-01NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RLC LLC Neuroradiology CurrentSince Sep 1, 2024 Accepting new patients
Mori Bean and Brooks Inc Neuroradiology CurrentSince Mar 1, 2020 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Jan 16, 2024 Accepting new patients
Nuvance Health Medical Practice PC CurrentSince Apr 1, 2026 Accepting new patients
University of Florida Jacksonville Physicians Inc Neuroradiology CurrentSince Aug 31, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 31, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Diagnostic Radiology Current Accepting new patients
Radiology Associates of South Florida LLC Diagnostic Radiology CurrentSince Mar 1, 2021 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 28, 2024 Accepting new patients
Radiology Associates of the Main Line P C Diagnostic Radiology Past Accepting new patients
Bay Radiology Associates, PL Diagnostic Radiology PastSince Jul 12, 2004 Accepting new patients
Main Line Health Imaging LP Diagnostic Radiology Past Accepting new patients
Bay Radiology Womens Imaging Center, LLC Diagnostic Radiology PastSince Jan 4, 2010 Accepting new patients
Elite Imaging, LLC Diagnostic Radiology Past Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

677 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 571-9599

901 W Rex Allen Dr
Willcox, AZ 85643
Phone (520) 384-3541

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1215 Dunn Ave
Ste A
Jacksonville, FL 32218
Phone (904) 696-8400

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

Networks

  • Freedom Health HMO Network

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 6

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1609938281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-4443",
            "fax_number": "239-436-5907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZEKAS",
        "first_name": "JESSICA",
        "middle_name": "EDEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS16388",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "240861-01",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MB08623000",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "010710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.