Kevin Lee Svancara, D.O.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

006549 Issued in AZ

Practice address

2620 N 140TH Ave # 103
Goodyear, AZ 85395-2437

Phone

(623) 219-4777

Fax

(623) 219-4778

NPI assigned

Jun 13, 2013

Last updated

Feb 20, 2025By 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 3

Addresses

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

Arizona College of Osteopathic Medicine Mid Western University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Sky Dermatology LLCGroup PAC ID 5496028607, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.97 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

63.24

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Clear Sky Dermatology LLC

  • Dermatology Physician
  • Goodyear, AZ
  • NPI 1306369996
  Medicare reassignment Care Compare group NPD Authorized official
• Vernon T Mackey, PC

  dba Advanced Desert Dermatology

  • Clinical & Laboratory Dermatological Immunology Physician
  • Peoria, AZ
  • NPI 1003204975
  NPD (past)

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1083052872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE # 103",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "623-219-4777",
            "fax_number": "623-219-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE # 103",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "623-219-4777",
            "fax_number": "623-219-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVANCARA",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "006549",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "OR",
            "license": "PG163096",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "6549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunrise Assisted Living Home LLC (Sunrise Assisted Living Home)
• Sunrise Mountain Behavioral Health
• Super Cool Kids Therapy, LLC
• Surgicalist of Az PLLC
• Zachary Sutton, DO
• SVS Physical Therapy, LLC
• Valerie Swanson
• Matthew D Sweeney, PA-C
• Tiffany Jonique Sylvester
• Justyna Szarkowska, RD

• MOHS-Micrographic Surgery Physician in Goodyear, AZ
• Providers in Goodyear, 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 Feb 20, 2025; 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.