Aap Dermatology & Cosmetic Surgery, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2012 Issued in AZ

Legal business name

AAP DERMATOLOGY & COSMETIC SURGERY, P.C.

Practice address

3940 E University Dr
Suite One
Mesa, AZ 85205-6945

Phone

(480) 924-9235

Fax

(480) 832-5501

NPI assigned

May 17, 2007

Last updated

Feb 9, 2022By 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. Ronald M Glick, D.O.NPI 1235134412

Title

President

Phone

(480) 924-9235

Specialties & licenses 1

Addresses

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 3

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.

• Ronald M Glick, D.O.

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1235134412
  Medicare reassignment NPD Authorized official
• Natalia Mahoney

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1538716717
  Medicare reassignment
• Mark Weaver, PA

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1801274600
  Medicare reassignment

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1174730147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056945",
            "telephone_number": "480-924-9235",
            "fax_number": "480-832-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 E UNIVERSITY DR",
            "address_2": "SUITE ONE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056945",
            "telephone_number": "480-924-9235",
            "fax_number": "480-832-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAP DERMATOLOGY & COSMETIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-924-9235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "2012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Abad

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.