W Milyani MD PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

W MILYANI MD PLLC

Doing business as

Frontier Skin and Cancer

Practice address

1951 Mesquite Ave Ste F
Lake Havasu City, AZ 86403-5746

Phone

(725) 867-7126

NPI assigned

May 9, 2022

Last updated

Jan 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clinton Martin, PA-CNPI 1013228394

Title

Member

Phone

(928) 963-9333

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Frontier Skin and Cancer Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clinton Richard Martin, P.A.

  • Physician Assistant
  • Lake Havasu City, AZ
  • NPI 1013228394
  Medicare reassignment Care Compare group Authorized official
• Chester Borge, PA-C

  • Physician Assistant
  • Miami, FL
  • NPI 1831064674

  AZ

  Medicare reassignment Care Compare group NPD
• Robert Leposavic, M.D.

  • MOHS-Micrographic Surgery Physician
  • Santa Barbara, CA
  • NPI 1396847182

  AZ, Dermatology

  Medicare reassignment Care Compare group NPD
• Kayla Barnett, PA-C

  • Physician Assistant
  • Fort Mohave, AZ
  • NPI 1548080963
  Medicare reassignment Care Compare group
• Christopher Jackson Turnbull

  • Physician Assistant
  • Lake Havasu City, AZ
  • NPI 1538896238
  Medicare reassignment Care Compare group
• Craig S Sink

  • Physician Assistant
  • Anchorage, AK
  • NPI 1811045552

  AZ

  Medicare reassignment Care Compare group
• Wael H Milyani, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Smyrna, GA
  • NPI 1497089874

  AZ

  Medicare reassignment NPD
• Vanessa Vu

  • Physician Assistant
  • Sierra Vista, AZ
  • NPI 1558077016
  Medicare reassignment
• Alexis D Elliott, PA

  • Physician Assistant
  • Silverdale, WA
  • NPI 1720548753

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1104562404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 W SAHARA AVE # 105-1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 MESQUITE AVE STE F",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035746",
            "telephone_number": "725-867-7126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Mohave Rd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "AZ",
            "postal_code": "853446349",
            "country_code": "US",
            "telephone_number": "928-963-9333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "W MILYANI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "928-963-9333",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013228394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396847182",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497089874",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538896238",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "clintmartin@directmail.com",
            "affiliation": "N",
            "address_1": "1951 Mesquite Ave Ste F",
            "city": "Lake Havasu City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864035746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drLeposavic@directmail.com",
            "affiliation": "N",
            "address_1": "1951 Mesquite Ave Ste F",
            "city": "Lake Havasu City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864035746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Frontier Skin and Cancer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jade Marie Vinatieri, FNP-BC
• Vip IV & Medical Spa, LLC
• Nicholas Virden, P.T., DPT
• Vision Care Center
• Emily E Vona, FNP-C
• Wal-Mart Store, Inc. (Vision Center 30-1364)
• Walgreen Co (Walgreens #05208)
• Kimberly Walker
• Matthew Wallender, PTA
• Walmart Inc. (Walmart Pharmacy 10-1364)

• MOHS-Micrographic Surgery Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, 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 Jan 9, 2023; 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.