Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. DESTINY M WAGGONER PH.D.
NPI 1235582727
Psychologist in Albuquerque, NM

Active since July 20, 2016PECOS Enrolled
306 SAN PABLO ST SE, ALBUQUERQUE, NM 87108(505) 272-0415 Get Directions Write a Review

NPPES record last updated: October 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 29, 2026, Jul 5, 2023, Oct 14, 2019 and 2 more (5 updates tracked since 2017).

About Dr. Destiny M Waggoner Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DESTINY M WAGGONER PH.D. (NPI 1235582727) is an individual psychologist in Albuquerque, New Mexico, licensed in New Mexico (PSY1566) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235582727
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. DESTINY M WAGGONERCredential: PH.D.
Location Address306 SAN PABLO ST SEAlbuquerque, NM 87108
Mailing Address306 San Pablo St SeAlbuquerque, NM 87108-3167 · (505) 272-9242
Sole ProprietorNo
Enumeration DateJuly 20, 2016
Last NPPES UpdateOctober 29, 20265 updates tracked since enumeration
NPPES CertifiedOctober 29, 2026
✔ NPI 1235582727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in NM · PSY1566
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
306 SAN PABLO ST SE, Albuquerque, NM 87108

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Destiny M Waggoner Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Destiny Waggoner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

General Acute Care Hospital
2211 LOMAS BLVD., N.E.
Albuquerque, NM 87106
  • Reassigned Medicare billing, New Mexico enrollment
  • 505 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108
Social Worker (Clinical)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108
Social Worker (Clinical)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108
Counselor (Mental Health)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108
Social Worker (Clinical)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108
Social Worker (Clinical)
306 SAN PABLO ST SE
ALBUQUERQUE, NM 87108

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Destiny Waggoner's NPI number?

The NPI number for Destiny Waggoner is 1235582727. It was assigned to this individual provider in the NPPES registry on July 20, 2016.

Where is Destiny Waggoner located?

Destiny Waggoner practices at 306 San Pablo St SE, Albuquerque, NM 87108. The listed phone number is (505) 272-0415.

What is Destiny Waggoner's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Destiny Waggoner enrolled in Medicare?

Yes. Destiny Waggoner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Destiny Waggoner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Destiny Waggoner reassigns Medicare benefits to Unm Hospital (Albuquerque, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Destiny Waggoner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Destiny Waggoner was last updated on October 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.