Individual provider Active NPI

Richard Allen Cirelli, M.D

  • Dermatology Physician
  • Prescott, AZ
National Provider Identifier
1265439335
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
27370 Issued in AZ
Practice address
955 Black Dr
Prescott, AZ 86305-1403
Phone
(928) 445-7546
Fax
(928) 445-7598
NPI assigned
Jul 5, 2005
Last updated
Oct 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 27370 AZ
Pediatric Dermatology Physician 207NP0225X 27370 AZ
Procedural Dermatology Physician 207NS0135X 27370 AZ
Dermatology Physician 207N00000X 27370 AZ Primary

Addresses

Primary practice location

955 Black Dr
Prescott, AZ 86305-1403

Mailing address

955 Black Dr
Prescott, AZ 86305-1403
Phone (928) 445-7546

Other identifiers 1

IdentifierTypeStateIssuer
465155MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110228000943 AZ Practitioner - Dermatology 8224013610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Hahnemann University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

955 Black Dr
Suite a
Prescott, AZ 86305-1403
Phone (928) 445-7546

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as individual
Quality
95.71
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision430
Removal of skin lesions3378
Skin biopsy745

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27370AZMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Cirelli, MD, PC Dermatology CurrentSince Feb 1, 2003 Accepting new patients
Arizona Associates in Dermatology and Cosmetic Surgery, LLC Dermatology Past Accepting new patients

Locations

955 Black Dr
Prescott, AZ 86305
Phone (928) 445-7546

955 Black Dr
Ste A
Prescott, AZ 86305
Phone (928) 445-7546

980 Willow Creek Rd
Ste 203
Prescott, AZ 86301
Phone (928) 445-5261

3262 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 771-5595

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1265439335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 BLACK DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051403",
            "telephone_number": "928-445-7546",
            "fax_number": "928-445-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BLACK DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051403",
            "telephone_number": "928-445-7546",
            "fax_number": "928-445-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRELLI",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "27370",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "AZ",
            "license": "27370",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "27370",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "27370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465155",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.