Jeffrey Dickman, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

009276 Issued in AZ

Practice address

4801 E McDowell Rd Ste 150
Phoenix, AZ 85008-7725

Phone

(602) 954-3919

Fax

(602) 954-3670

NPI assigned

Mar 21, 2019

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omni Dermatology IncorporatedGroup PAC ID 5698846558, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.59 of 100Reported as group

Quality

65

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6619/brand/1/csg/1/fhir/r4
• Direct secure messaging: j.dickman@omnidermatology.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omni Dermatology Incorporated

  • Dermatology Physician
  • Glendale, AZ
  • NPI 1003082090
  Medicare reassignment Care Compare group NPD
• Alta Dermatology Group LTD

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1780801506
  NPD (past)
• Integrated Dermatology of Mesa PLLC

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1922378850
  NPD (past)

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1225598675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W OLIVE AVE STE 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023147",
            "telephone_number": "623-299-9540",
            "fax_number": "623-299-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 E MCDOWELL RD STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087725",
            "telephone_number": "602-954-3919",
            "fax_number": "602-954-3670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9305 W Thomas Rd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373369",
            "country_code": "US",
            "telephone_number": "623-478-8000",
            "fax_number": "623-478-8003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 W Olive Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853023147",
            "country_code": "US",
            "telephone_number": "623-299-9540",
            "fax_number": "623-299-9530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4515 S McClintock Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852827381",
            "country_code": "US",
            "telephone_number": "602-559-5470",
            "fax_number": "602-559-5471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "JEFFREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "009276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Maurine Dickinson, RN, CDE
• Doreen Sisk Dickinson, LPC
• Lidia Teresa Dickinson, RPH
• Curtis A Dickman, MD
• David Stanford Dickman, M.D.
• Raechel Dickman, DO
• Madeline Ann Dicks, D.O.
• Anna Jacquelyn Dickson
• Adrian J Dida, RBT
• Diduro Chiropractic and Associates PC

• 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 Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.