Individual provider Active NPI

Stephanie Ann McLeish, M.D.

  • Dermatology Physician
  • Anchorage, AK
National Provider Identifier
1104850460
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
119435 Issued in AK
Practice address
3841 Piper St Ste T4-020
Anchorage, AK 99508-4673
Phone
(907) 646-8500
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 119435 AK Primary

Addresses

Primary practice location

3841 Piper St Ste T4-020
Anchorage, AK 99508-4673

Mailing address

2440 E Tudor Rd
Anchorage, AK 99507-1185
Phone (830) 730-0680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, AZ, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170915001426 AK Practitioner - Dermatology 1254317985 Reassigns benefits to 1 organization
I20231003003793 AZ Practitioner - Dermatology 1254317985 Reassigns benefits to 1 organization
I20260609000230 VA Practitioner - Dermatology 1254317985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6160 Kempsville Cir
Suite 200a
Norfolk, VA 23502-3914

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions73
Removal or shaving of skin growth1-10
Skin biopsy27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm - Blackhart PLLC Dermatology CurrentSince Oct 1, 2019 Accepting new patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Oct 1, 2019 Accepting new patients
Thomas Dermatology Dermatology CurrentSince Sep 1, 2023 Accepting new patients
Douglas a. Thomas, MD Dermatology Past Accepting new patients

Locations

3841 Piper St
Ste 20
Anchorage, AK 99508
Phone (907) 646-8500

3841 Piper St
Anchorage, AK 99508
Phone (907) 563-3103

3841 Piper St
Ste T4-020
Anchorage, AK 99508
Phone (907) 646-8500

1815 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 753-2888

1801 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (702) 430-5333

9097 W Post Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 430-5333

Interoperability endpoints

  • Direct secure messaging: smcleash@thomasderm.emadirect.md

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1104850460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071185",
            "telephone_number": "830-730-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST STE T4-020",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084673",
            "telephone_number": "907-646-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEISH",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AK",
            "license": "119435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.