Nicole Alissa Deatherage
Anatomic Pathology & Clinical Pathology Physician · Tucson, AZ
Nicole Alissa Deatherage is an anatomic pathology & clinical pathology physician with a practice address in Tucson, Arizona, and NPI 1417691338, issued on Apr 26, 2022. Check the license (Arizona R79300, as entered in NPPES) on the Arizona Medical Board; the Medicare figures below come from public CMS files.
- Name
- Nicole Alissa Deatherage
- Primary taxonomy
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License number
- R79300 AZ
Self-reported in NPPES; status is on the state search - Practice location
- 1625 N Campbell Ave, Tucson, AZ 85719
- Phone
- (520) 626-6830
- Enumerated
- Apr 26, 2022
- Record last updated
- Apr 26, 2022
- Entity
- Type 1 · individual
Also registered at 1625 N Campbell Ave
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Kristopher Abbate, MDInternal Medicine Physician1184112401
- Michelle Abbate, MDObstetrics & Gynecology Physician1184111940
- Abdelrahman AbdallaDiagnostic Radiology Physician1457139339
- Jonathan Abdo, MDStudent in an Organized Health Care Education/Training Program1811783814
- Kalkidan Abebe, MDInternal Medicine Physician1508435504
- Sameer Aboufadel, DO, MPHEmergency Medicine Physician1639063431
Verify Nicole Alissa Deatherage in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersArizona Medical Board
Search for license R79300Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Industry payments in 2024: $18.68
1 payment: food and beverage; the largest payer was Shionogi Inc. The 2,607 providers of this specialty with any payment received $3,565.00 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Anatomic Pathology & Clinical Pathology Physician providers in Arizona
There are 324 anatomic pathology & clinical pathology physician records in Arizona.
Other anatomic pathology & clinical pathology physician records in Arizona
- Osama Abdelatif, M.D.Tucson, AZ1003904020
- Ahmed Aboul-Nasr, MDTucson, AZ1457934879
- Khalid Aboul-Nasr, M.D.Tucson, AZ1235579293
- Rashad Aboul-Nasr, MDTempe, AZ1053409078
- Sara Afraz, MDPhoenix, AZ1336751403
- Irene Aguilera-Barrantes, M.D.Casa Grande, AZ1669688719
- Maria Aguirre, M.D.Sun City, AZ1669447645
- Raheel Ahmed, MD/MPHPhoenix, AZ1134626518
- Saime Aksoy, M.D.Phoeniz, AZ1770566226
- Yousif Al Rubaye, MDPhoenix, AZ1952864761
Common questions
What is Nicole Alissa Deatherage's NPI number?
Nicole Alissa Deatherage's National Provider Identifier (NPI) is 1417691338, issued on Apr 26, 2022. An NPI identifies a provider in billing; it is not a license.
Where is Nicole Alissa Deatherage located?
The NPPES record lists a practice address at 1625 N Campbell Ave, Tucson, AZ, 85719. Phone: (520) 626-6830. Providers update this record themselves, so call before visiting.
How can I verify Nicole Alissa Deatherage's license?
NPPES lists Arizona license number R79300, as entered by the provider. Search the Arizona Medical Board at https://www.azmd.gov/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.