Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Ellen Radosevich, FNP-C

Individual provider Nurse Practitioner · NPI 1245534726

Mary Ellen Radosevich, FNP-C is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2010, 16 years ago. Practices with Banner Primary Care Physicians Arizona LLC, a 237-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
16
Licensed in
AZ
In the registry since
2010
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

4375 E Irma Ln
Phoenix, AZ 85050-4312
Phone: (480) 890-5800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP3727 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence AP3727 (AZ)

Record details

NPI number1245534726
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedDecember 27, 2010
Last updated in NPPESMarch 16, 2025
Certification dateMarch 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Banner Primary Care Physicians Arizona Llc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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