Individual provider Active NPI

Jessie Marie Pettit, MD

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1821232216
Registry record updated Apr 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41805 Issued in AZ
Practice address
4008 E Pima St
Tucson, AZ 85712-3317
Phone
(520) 326-0850
Fax
(520) 326-0849
NPI assigned
Apr 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41805 AZ Primary

Addresses

Primary practice location

4008 E Pima St
Tucson, AZ 85712-3317

Mailing address

2980 N Swan Rd Ste 225
Tucson, AZ 85712-6024
Phone (520) 276-6255

Other practice location 1

2980 N Swan Rd Ste 225
Tucson, AZ 85712-6024
Phone (520) 276-6255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000147 AZ Practitioner - Family Practice 3173673258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banyan Integrative Health LLCGroup PAC ID 4587904594, 2 clinicians

Practice addresses (Care Compare)

4008 E Pima St
Tucson, AZ 85712-3317
Phone (520) 326-0850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41805AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evan W Kligman M D P C CurrentSince Mar 1, 2022 Accepting new patients

Locations

2802 N Alvernon Way
Ste 200
Tucson, AZ 85712
Phone (520) 326-0850

Interoperability endpoints

  • Direct secure messaging: jessie.pettit.1@3372.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775952000000",
    "number": "1821232216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N SWAN RD STE 225",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126024",
            "telephone_number": "520-276-6255",
            "fax_number": "520-525-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 E PIMA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123317",
            "telephone_number": "520-326-0850",
            "fax_number": "520-326-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2980 N Swan Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857126024",
            "country_code": "US",
            "telephone_number": "520-276-6255",
            "fax_number": "520-525-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "JESSIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "41805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.