Brooke Leigh Blumetti, DO
Individual provider Active NPI Dermatology Physician · Phoenix, AZ
NPI 1245488444 · NPPES record last updated Mar 19, 2023
Key facts
- NPI
- 1245488444
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 005682 (AZ)
- Practice address
- 3815 E Bell Rd Ste 3100
Phoenix, AZ 85032-2156 - Phone
- (480) 916-3376
- Fax
- (602) 835-2698
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Ohio University, College of Osteopathic Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Carlos Apache Healthcare Corporation
Associates in Dermatology Care PLLC
Gila River Health Care Corporation
Desert Valley Dermatology PLC
Practice addresses (Care Compare)
103 Medicine Way Rd
Peridot, AZ 85542-0787
Phone (928) 475-1400
11000 N Scottsdale Rd
Suite 120
Scottsdale, AZ 85254-6169
Phone (480) 596-1110
3042 W Queen Creek Rd
Hu Hu Kam Memorial Hospital
Chandler, AZ 85286-0038
Phone (520) 796-2620
3815 E Bell Rd
Suite 3100
Phoenix, AZ 85032-2156
Phone (602) 835-2699
P O Box
Suite 787
Peridot, AZ 85542-0787
PO Box
Suite 787
Peridot, AZ 85542-0787
Hospital & facility affiliations
- Huhu Kam Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 15 |
| Removal of skin lesions | 1007 |
| Removal of skin cancer | 70 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 341 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110926000913 | AZ | Practitioner - Dermatology | 5395926521 | Reassigns benefits to 2 organizations |
| I20170530001850 | TX | Practitioner - Dermatology | 5395926521 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101017943 | MI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gila River Health Care Corporation | Current | Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| Gila River Health Care | Current |
Accepting new patients | |
| Gila River Health Care Corporation | Current |
Accepting new patients | |
| Desert Valley Dermatology PLC | Current |
Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| Richard Lee Averitte Jr PLLC | Dermatology | Past | Accepting new patients |
| Richard Lee Averitte Jr., PLLC | Past | Accepting new patients | |
| Richard Lee Averitte Jr., PLLC | Past | Accepting new patients |
Locations
17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
3815 E Bell Rd
Ste 3100
Phoenix, AZ 85032
Phone (480) 916-3376
Interoperability endpoints
- bblumetti@desertvalley.emadirect.md
- brookeblumetti@ad.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 5101017943 | MI | |
| Dermatology Physician | 207N00000X | 005682 | AZ | Yes |
Addresses
Primary practice location
3815 E Bell Rd Ste 3100
Phoenix, AZ 85032-2156
Mailing address
3815 E Bell Rd Ste 3100
Phoenix, AZ 85032-2156
Phone (480) 916-3376
Other providers in Phoenix, AZ
- Judith A Bluff
- Stacy Gittel Blum
- Annette Harris Blume
- Lauren Blumenthal
- Rachael Beth Blumenthal
- Kedra Jane Blunck
- Kelly Maureen Blunk
- Lynn W Blunt Jr.
- Blupeak Hospice LLC
- George Joseph Bluth
All providers in Phoenix, AZ · Dermatology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.