Mayo Clinic Arizona

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MAYO CLINIC ARIZONA

Doing business as

Mayo Clinic Building Phoenix Outpatient Pharmacy

Practice address

5881 E Mayo Blvd
# Ste 1-304
Phoenix, AZ 85054-4505

Phone

(480) 342-4100

Fax

(480) 342-4180

NPI assigned

Dec 15, 2015

Last updated

Aug 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roshanak Didehban

Title

Cao

Phone

(480) 301-6493

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mayo Clinic Building Phoenix Outpatient Pharmacy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mayo Clinic Arizona

  dba Mayo Clinic Hospital

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1154392231

  O20040210000729

  Same enrollment
• Mayo Clinic Arizona

  dba Mayo Clinic Scottsdale

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1255302113

  O20040210000729

  Same enrollment
• Mayo Clinic Arizona

  dba Mayo Clinic Scottsdale

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1528039484

  O20040210000729

  Same enrollment

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mayo Clinic

  • Air Ambulance
  • Rochester, MN
  • NPI 1821326570

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1255796496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 083268",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606910268",
            "telephone_number": "507-284-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 E MAYO BLVD",
            "address_2": "# STE 1-304",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544505",
            "telephone_number": "480-342-4100",
            "fax_number": "480-342-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "DIDEHBAN",
        "authorized_official_first_name": "ROSHANAK",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "480-301-6493"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "AZ",
            "license": "Y006569",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155895",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Building Phoenix Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Building Phoenix Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mayne Medical, LLC
• Brett M. Mayne, PA
• Shari Mayne
• Domingo L Maynes III, M.D.
• Mayo Clinic Arizona (Mayo Clinic Hospital)
• Mayo Clinic Arizona (Mayo Clinic Phoenix Oncology Pharmacy)
• Mayo Clinic Arizona (Mayo Clinic Specialty Building)
• Mayo Clinic Arizona
• Mayo Clinic Arizona (Mayo Clinic Hospital Out Patient Pharmacy)
• Mayo Foundation for Medical Education & Research (Mayo Clinic Store - Flower of Hope)

• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.