Organization Active NPI

Ocotillo Dermatology, PLLC

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1053871384
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OCOTILLO DERMATOLOGY, PLLC
Practice address
3930 S Alma School Rd Ste 8
Chandler, AZ 85248-4510
Phone
(480) 917-4815
Fax
(480) 963-2654
NPI assigned
Mar 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Dr. Joseph David Allgeier, DONPI 1144253071
Title
Owner
Phone
(480) 625-7975

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3930 S Alma School Rd Ste 8
Chandler, AZ 85248-4510

Mailing address

1805 W Sparrow Dr
Chandler, AZ 85286-5172
Phone (480) 625-7975

Other identifiers 1

IdentifierTypeStateIssuer
707265MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190719000523 AZ Part B Supplier - Clinic/Group Practice 1153657762 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00225

Practitioners & affiliated clinicians

Practitioners 1

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": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1053871384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 W SPARROW DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852865172",
            "telephone_number": "480-625-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 S ALMA SCHOOL RD STE 8",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484510",
            "telephone_number": "480-917-4815",
            "fax_number": "480-963-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "ALLGEIER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-625-7975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707265",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.