Anthony John Petelin, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

45164 Issued in AZ

Practice address

14275 N 87TH St
Suite #110
Scottsdale, AZ 85260-3696

Phone

(480) 905-8485

Fax

(480) 905-7274

NPI assigned

Aug 15, 2008

Last updated

Nov 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Arizona College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.72 of 100Reported as individual

Quality

84.94

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Dermatology, PLLC

  dba Arizona Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1194792416
  Medicare reassignment Care Compare group
• Dyson Dermatology PLLC

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1215291414
  Medicare reassignment
• Center for Dermatology, PLLC

  • Medical Physician Assistant
  • Scottsdale, AZ
  • NPI 1174062673
  NPD (past)
• Dyson Dermatology PLLC

  • Dermatology Physician
  • Green Valley, AZ
  • NPI 1396500476
  NPD (past)
• Scottsdale Center for Sight, PLC

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1265591374
  NPD (past)
• Ultrasound Institute Medical Group, Inc.

  • Sonography Radiologic Technologist
  • Phoenix, AZ
  • NPI 1932419090
  NPD (past)
• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1063668531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 N 87TH ST",
            "address_2": "SUITE #110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603696",
            "telephone_number": "480-905-8485",
            "fax_number": "480-905-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14275 N 87TH ST",
            "address_2": "SUITE #110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603696",
            "telephone_number": "480-905-8485",
            "fax_number": "480-905-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETELIN",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A103734",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "45164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9778761",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patress Ann Persons, MD
• Nichole Maria Peru, MA, BCBA, LBA
• Chelsey Pestello, CRNA
• Kristin E Petcher, PA
• Pete N Mellas DMD Ms PLLC
• Paul M Petelin Sr., MD
• Paul M Petelin Jr., MD
• Peter J. Ferrara M.D. P.C.
• Christine Peters
• Claudia M Peters, R.N.

• MOHS-Micrographic Surgery Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• MOHS-Micrographic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.