Individual provider Active NPI

Jessie-Anne Penkoff, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Tucson, AZ
National Provider Identifier
1043863350
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Practice address
3838 N Campbell Ave BLDG 2
Tucson, AZ 85719-1454
Phone
(520) 694-6393
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X Primary

Addresses

Primary practice location

3838 N Campbell Ave BLDG 2
Tucson, AZ 85719-1454

Mailing address

8314 N Firethorn Ave
Tucson, AZ 85741-1009
Phone (480) 201-9630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318000668 AZ Practitioner - Qualified Audiologist 1355773128 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Mar 1, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Mar 1, 2025 Accepting new patients
Banner-University Medical Group Current Accepting new patients
Adam Dipuccio LLC Audiologist Past Accepting new patients

Locations

3838 N Campbell Ave
#2
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

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

1625 N Campbell Ave
Tucson, AZ 85719

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1043863350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8314 N FIRETHORN AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857411009",
            "telephone_number": "480-201-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE BLDG 2",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191454",
            "telephone_number": "520-694-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENKOFF",
        "first_name": "JESSIE-ANNE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.