Individual provider Active NPI

Destiny Ortiz

  • Community/Retail Pharmacy
  • Tucson, AZ
National Provider Identifier
1255014163
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
S026391 Issued in AZ
Practice address
1221 W Irvington Rd
Tucson, AZ 85714-1167
Phone
(520) 434-6921
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X S026391 AZ Primary

Addresses

Primary practice location

1221 W Irvington Rd
Tucson, AZ 85714-1167

Mailing address

3278 W Montana St
Tucson, AZ 85746-1006
Phone (520) 349-4376

Other practice location 1

3278 W Montana St
Tucson, AZ 85746-1006
Phone (520) 349-4376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S026391AZMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Raley'S Arizona LLC Community/Retail Pharmacy PastSince Aug 13, 2023 Accepting new patients
Raley'S Arizona LLC Community/Retail Pharmacy PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 2

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1255014163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3278 W MONTANA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857461006",
            "telephone_number": "520-349-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W IRVINGTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141167",
            "telephone_number": "520-434-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3278 W Montana St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857461006",
            "country_code": "US",
            "telephone_number": "520-349-4376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "DESTINY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "S026391",
            "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 Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.