Southwest Skin Specialists LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

98010735 Issued in AZ

Legal business name

SOUTHWEST SKIN SPECIALISTS LLC

Practice address

11130 N Tatum Blvd
Suite 100
Phoenix, AZ 85028-1630

Phone

(602) 494-1817

Fax

(602) 494-7103

NPI assigned

Jul 13, 2005

Last updated

Sep 6, 2017By 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

Dr. Howard Jay Luber, M. D.NPI 1679596530

Title

President

Phone

(602) 494-1817

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Southwest Skin Specialists, LLC

  dba Southwest Skin Specialists, LTD /

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1609185347

  O20040319001063

  Same enrollment

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

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Beatrice Keller Clinic, PC

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1467402933

  Member Of

  NPD member

Locations

Practitioners 70

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.

• Lindsay Skye Ackerman, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609900299
  Medicare reassignment Care Compare group NPD
• Florencia Anatelli, MD

  • Dermatopathology (Pathology) Physician
  • Scottsdale, AZ
  • NPI 1053408849
  Medicare reassignment Care Compare group NPD
• Katharine M Bermingham Cordova, MD

  • MOHS-Micrographic Surgery Physician
  • Sun City West, AZ
  • NPI 1396962767

  Dermatology

  Medicare reassignment Care Compare group NPD
• Rachel Lauren Cetta, DO

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1942681655

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Miriam Paulette Cummings, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174546444
  Medicare reassignment Care Compare group NPD
• Samuel Devictor, MD

  • Facial Plastic Surgery Physician
  • Scottsdale, AZ
  • NPI 1619301884
  Medicare reassignment Care Compare group NPD
• Melissa F Efron-Everett, M.D.

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1588956361
  Medicare reassignment Care Compare group NPD
• Troy C Ellis, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1356491997
  Medicare reassignment Care Compare group NPD
• Jennifer Fernandez, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1972182939
  Medicare reassignment Care Compare group NPD
• James Patrick Foshee, MD

  • MOHS-Micrographic Surgery Physician
  • Phoenix, AZ
  • NPI 1689037152

  Dermatology

  Medicare reassignment Care Compare group NPD
• Mary F Fredenberg, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1134140999
  Medicare reassignment Care Compare group NPD
• Joseph Michael Giancola, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1265455539
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504656000000",
    "number": "1174521926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST",
            "address_2": "#205",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584534",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 N TATUM BLVD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281630",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SKIN SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2017-09-06",
        "status": "A",
        "authorized_official_last_name": "LUBER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-494-1817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "98010735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Pediatrics Payment Processing, LLC
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• Southwest Phoenix Urgent Care LLC (NextCare)
• Southwest Physiatry PLLC
• Southwest Serenity Counseling LLC
• Southwest Sleep Disorders Lab LLC
• Southwest Spine and Orthopedic Center PLLC
• Southwest Sports Medicine and Rehabilitation LLC (FYZICAL Therapy and Balance Center Phoenix Midtown)
• Southwest Surgery Services, LLC
• Southwest Therapy Specialists, P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.