OLD PUEBLO PEDIATRICS
NPI 1376723999
Contractor in Tucson, AZ

Q: What is Old Pueblo Pediatrics's NPI number?

The NPI number for Old Pueblo Pediatrics is 1376723999. It was assigned to this organization in the NPPES registry on November 12, 2007.

Q: What is Old Pueblo Pediatrics's specialty?

The primary specialty registered for this NPI is Contractor with taxonomy code 171W00000X.

Active since November 12, 2007CLIA 03D1051772 · Waiver

3043 W INA RD STE 115, TUCSON, AZ 85741(520) 797-7070(520) 797-7077 Get Directions Write a Review

NPPES record last updated: November 12, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Old Pueblo Pediatrics NPPES

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

OLD PUEBLO PEDIATRICS (NPI 1376723999) is a healthcare organization registered as a contractor in Tucson, Arizona and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through March 9, 2028 and lists John Ray Bean, President, as its authorized official.

NPPES Registry Identity

NPI1376723999

Entity TypeOrganization

Primary Taxonomy171W00000X

Legal Business NameOLD PUEBLO PEDIATRICS

Location Address3043 W INA RD STE 115Tucson, AZ 85741-2107

Mailing Address7320 N La Cholla Blvd # 154-501Tucson, AZ 85741-2309 · (520) 797-7070 · Fax (520) 797-7077

Phone(520) 797-7070

Fax(520) 797-7077

Organization SubpartNo

Authorized OfficialJohn Ray BeanPresident · (520) 797-7070

Enumeration DateNovember 12, 2007

✔ NPI 1376723999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyContractorOther Service Providers

Taxonomy Code171W00000X

Definition

For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no relation to a provider's employment status.

3043 W INA RD STE 115, Tucson, AZ 85741

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D1051772

Old Pueblo Pediatrics, PLLC · Tucson, AZ

Active · expires Mar 9, 2028

CLIA Number03D1051772

Laboratory TypePhysician Office

Certificate Effective DateMarch 10, 2026

Certificate Expiration DateMarch 9, 2028

Laboratory DirectorZebulon Delp

Laboratory Phone(520) 797-7070

Laboratory LocationOld Pueblo Pediatrics, PLLC3043 West Ina Rd, Ste 115, Tucson, AZ 85741

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

ACACIA PACKER DO

Pediatrics