NPIMap

Organization Active NPI

J. Robert West, M.D., Inc

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1114567997
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
J. ROBERT WEST, M.D., INC
Practice address
12251 N 32ND St Ste 12
Phoenix, AZ 85032-7144
Phone
(602) 971-0950
NPI assigned
Jan 9, 2020
Organization subpart
Yes
Parent organization
J. ROBERT WEST, M.D., INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Mr. Kara Foley III
Title
Credentialing
Phone
(702) 360-2763

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

12251 N 32ND St Ste 12
Phoenix, AZ 85032-7144

Mailing address

12700 Park Central Dr Ste 1210
Dallas, TX 75251-1522
Phone (702) 360-2763

Other names 1

  • West Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090813000213 AZ Part B Supplier - Clinic/Group Practice 8729990973 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
West Dermatologysurg Med GR

Locations

1242 E McKellips Rd
Ste 103
Mesa, AZ 85203
Phone (480) 535-0738

3102 E Indian School Rd
Ste 140
Phoenix, AZ 85016
Phone (602) 266-0266

653 N Town Center Dr
Ste 214
Las Vegas, NV 89144
Phone (702) 248-8989

2650 N Tenaya Way
Ste 208
Las Vegas, NV 89128
Phone (702) 360-2100

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 119

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1114567997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 PARK CENTRAL DR STE 1210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511522",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 N 32ND ST STE 12",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327144",
            "telephone_number": "602-971-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. ROBERT WEST, M.D., INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J. ROBERT WEST, M.D., INC",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "FOLEY",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "702-360-2763",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.