Individual provider Active NPI

Amy A Huber, MD

  • MOHS-Micrographic Surgery Physician
  • Memphis, TN
National Provider Identifier
1215904602
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD35480 Issued in TN
Practice address
1455 Union Ave
Memphis, TN 38104-6727
Phone
(901) 726-6655
Fax
(901) 726-9056
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X MD35480 TN
MOHS-Micrographic Surgery Physician 207ND0101X MD35480 TN Primary
Dermatopathology Physician 207ND0900X MD35480 TN

Addresses

Primary practice location

1455 Union Ave
Memphis, TN 38104-6727

Mailing address

1455 Union Ave
Memphis, TN 38104-6727
Phone (901) 726-6655

Other practice location 1

795 Ridge Lake Blvd Ste 200
Memphis, TN 38120-9475
Phone (901) 726-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100920000936 TN Practitioner - Micrographic Dermatologic Surgery (MDS) 3476678061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)
Education
University of Tennessee, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Dermatology Clinic PAGroup PAC ID 2264507524, 11 clinicians

Practice addresses (Care Compare)

1455 Union Ave
Memphis, TN 38104-6727
Phone (901) 726-6655

Merit-based Incentive Payment System (MIPS)

Final score
81.3 of 100Reported as individual
Quality
62.61
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision82
Removal of skin lesions686
Removal of skin cancer1030
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy753

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD35480TNMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Dermatology Clinic PA Mohs-Micrographic Surgery CurrentSince Jul 15, 2003 Accepting new patients

Locations

1455 Union Ave
Memphis, TN 38104
Phone (901) 726-6655

795 Ridge Lake Blvd
Ste 200
Memphis, TN 38120
Phone (901) 726-6655

Organizations & group practices 1

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1215904602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Ridge Lake Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381209475",
            "country_code": "US",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "AMY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "MD35480",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "MD35480",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TN",
            "license": "MD35480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.