Dermatology & Skin Surgery Specialists of Arizona, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

49128 Issued in AZ

Legal business name

DERMATOLOGY & SKIN SURGERY SPECIALISTS OF ARIZONA, LLC

Doing business as

Dermatology & Skin Surgery Specialists

Practice address

8415 N Pima Rd
Suite 212
Scottsdale, AZ 85258-4480

Phone

(480) 434-6600

Fax

(480) 522-3528

NPI assigned

Dec 31, 2014

Last updated

Jan 9, 2015By 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

Anne James Goldsberry, MD

Title

Medical Director

Phone

(949) 233-5571

Specialties & licenses 1

Addresses

Other names 1

• Dermatology & Skin Surgery Specialists Doing business as

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 5

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.

• Aditi Thokala Chandra, DO

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1215517347
  Medicare reassignment Care Compare group NPD
• Helen Jia Liang Cumsky, MD

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1437612470
  Medicare reassignment Care Compare group NPD
• Anne James Walter, MD, MBA

  • Procedural Dermatology Physician
  • Scottsdale, AZ
  • NPI 1457581019
  Medicare reassignment Care Compare group NPD
• Meghan Leigh Dickerson, PA-C

  • Physician Assistant
  • Scottsdale, AZ
  • NPI 1750770541
  Medicare reassignment Care Compare group
• Jacqueline Elizabeth Vercauteren

  • Physician Assistant
  • Glendale, AZ
  • NPI 1467061697
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1144618943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 N PIMA RD",
            "address_2": "SUITE 212",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584480",
            "telephone_number": "480-434-6600",
            "fax_number": "480-522-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 N PIMA RD",
            "address_2": "SUITE 212",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584480",
            "telephone_number": "480-434-6600",
            "fax_number": "480-522-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & SKIN SURGERY SPECIALISTS OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "GOLDSBERRY",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "949-233-5571",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "49128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology & Skin Surgery Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rambod Derakhshani, DC
• Derek H. Lamb, DMD, MD, PLLC (Southwest Jaw Surgeons)
• Derek L. Thompson, MD PLLC
• Victoria Dereszkiewicz, LAT, ATC
• Dermatique, LTD
• Dermcall LLC
• Cheryl Marie Deroin, N.M.D.
• Derosa Medical, P.C.
• Angela Marie Derosa, D.O.
• Michelle Sharon Derosa, OTR/L

• Dermatology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.