ETHAN RADZINSKY
NPI 1114555430
Radiology - Diagnostic Radiology in San Jose, CA
About Ethan Radzinsky NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN RADZINSKY (NPI 1114555430) is an individual diagnostic radiology provider in San Jose, California, licensed in California (177745) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ethan Radzinsky is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Ethan Radzinsky reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Modesto, CA 95355
- Reassigned Medicare billing, California enrollment
- 3,056 clinicians in this Medicare group
Davis, CA 95616
- Reassigned Medicare billing, California enrollment
- 2,570 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN JOSE, CA 95128
SAN JOSE, CA 95128
SAN JOSE, CA 95128
SAN JOSE, CA 95128
SAN JOSE, CA 95128
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ethan Radzinsky's NPI number?
The NPI number for Ethan Radzinsky is 1114555430. It was assigned to this individual provider in the NPPES registry on March 31, 2020.
Where is Ethan Radzinsky located?
Ethan Radzinsky practices at 751 S Bascom Ave, San Jose, CA 95128. The listed phone number is (408) 885-5110.
What is Ethan Radzinsky's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Ethan Radzinsky enrolled in Medicare?
Yes. Ethan Radzinsky is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Ethan Radzinsky's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Radzinsky reassigns Medicare benefits to 2 organizations: Sutter Valley Medical Foundation (Modesto, CA) and Regents Of The Univ Of Ca (Davis, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Radzinsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ethan Radzinsky was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ethan Radzinsky · NPI 1114555430
Diagnostic Radiology physician in San Jose, California. Individual provider, active in the CMS NPPES registry since March 31, 2020.
## Identity
- **NPI:** 1114555430 (Entity type: Individual)
- **Enumerated:** March 31, 2020
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** 177745 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 751 S BASCOM AVE, San Jose, CA 95128-2604
- **Phone:** (408) 885-5110
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Sutter Valley Medical Foundation (NPI 1669846986, Modesto, CA); Regents Of The Univ Of Ca (NPI 1053304071, Davis, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** December 17, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1114555430) · Data from the CMS NPPES public registry.