NPIMap

Organization Active NPI

All Dermatology, Inc.

  • Dermatopathology Physician
  • Surprise, AZ
National Provider Identifier
1023199544
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
ALL DERMATOLOGY, INC.
Practice address
14239 W Bell Rd
Suite 101
Surprise, AZ 85374-2469
Phone
(623) 544-7755
Fax
(623) 544-8665
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Authorized official

Name
Mr. James F Pehoushek, M.D.NPI 1104810720
Title
Physician
Phone
(623) 544-7755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X Primary
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NI0002X
Pediatric Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NP0225X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

14239 W Bell Rd
Suite 101
Surprise, AZ 85374-2469

Mailing address

14239 W Bell Rd
Suite 101
Surprise, AZ 85374-2469
Phone (623) 544-7755

Other names 1

  • Allergy and Dermatology Specialists, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000757 AZ Part B Supplier - Clinic/Group Practice 4284527748 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Glendale, AZ; Surprise, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1002763All Dermatology14239 W Bell Rd Ste 101, Surprise, AZ 85374ComplianceJul 17, 2027

National Provider Directory

National Provider Directory

Locations

6320 W Union Hills Dr
Ste 210
Glendale, AZ 85308

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1023199544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "SUITE 101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-544-7755",
            "fax_number": "623-544-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "SUITE 101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-544-7755",
            "fax_number": "623-544-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "PEHOUSHEK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-544-7755",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allergy and Dermatology Specialists, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.