Az Dermatology

Primary specialty

SpecialistTaxonomy code 174400000X

License

36353 Issued in AZ

Legal business name

AZ DERMATOLOGY

Practice address

1840 W Apache TRL
Apache Junction, AZ 85120-3728

Phone

(480) 982-3337

Fax

(520) 374-2467

NPI assigned

Oct 8, 2009

Last updated

Oct 8, 2009By 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. Jayshri Gamoth, M.D.NPI 1851340467

Title

Owner

Phone

(520) 374-2462

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Az Dermatology

  • Specialist
  • Maricopa, AZ
  • NPI 1962737965

  O20080317000520

  Same enrollment
• Az Dermatology LLC

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1508035411

  O20080317000520

  Same enrollment
• Az Dermatology, LLC

  • Specialist
  • Yuma, AZ
  • NPI 1770818130

  O20080317000520

  Same enrollment

Locations

Practitioners 1

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.

• Jayshri Gamoth, MD

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1851340467
  Authorized official Same address or phone

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1235464231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 N TREKELL RD",
            "address_2": "SUITE",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221705",
            "telephone_number": "520-374-2462",
            "fax_number": "520-374-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 W APACHE TRL",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851203728",
            "telephone_number": "480-982-3337",
            "fax_number": "520-374-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "GAMOTH",
        "authorized_official_first_name": "JAYSHRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-374-2462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "36353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stacey L. Atkins, M.C.
• Joseph Bertrand D. Audette II, D.O.
• Avery's House LLC
• Awakening Recovery Center
• Owais Azharuddin, MD
• Azmo Medical Services, LLC
• Aztech Radiology and Open MRI
• Samuel D Bair, DPT
• Balancing Act Physical Therapy, LLC

• Specialist in Apache Junction, AZ
• Providers in Apache Junction, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.