Individual provider Active NPI

Joseph Michael Giancola, MD

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1265455539
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
21007 Issued in AZ
Practice address
11130 N Tatum Blvd
#100
Phoenix, AZ 85028-1662
Phone
(602) 494-1817
Fax
(602) 494-7103
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 21007 AZ Primary

Addresses

Primary practice location

11130 N Tatum Blvd
#100
Phoenix, AZ 85028-1662

Mailing address

11130 N Tatum Blvd
#100
Phoenix, AZ 85028-1662
Phone (602) 494-1817

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
I20040729000014 AZ Practitioner - Dermatology 8123098902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Columbia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

11130 N Tatum Blvd
Suite 100
Phoenix, AZ 85028-1630
Phone (602) 494-1817

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision170
Removal of skin lesions180
Removal of skin cancer1163
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy35

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin Specialists LLC Dermatology CurrentSince Oct 27, 1997 Accepting new patients
Southwest Skin Specialists, LLC CurrentSince Oct 27, 1997 Accepting new patients
Beatrice Keller Clinic, PC Dermatology Past Accepting new patients

Locations

11130 N Tatum Blvd
Phoenix, AZ 85028

1331 N 7th St
Ste 250
Phoenix, AZ 85006
Phone (602) 354-5770

4400 N 32nd St
Ste 140
Phoenix, AZ 85018
Phone (602) 254-1429

11130 N Tatum Blvd
Ste 100
Phoenix, AZ 85028
Phone (602) 494-1817

4845 E Thunderbird Rd
Ste 2
Scottsdale, AZ 85254
Phone (602) 494-1817

10200 N 92nd St
Ste 205
Scottsdale, AZ 85258
Phone (602) 494-1817

5310 Harvest Hill Rd
Ste 2900
Dallas, TX 75230

Interoperability endpoints

  • Direct secure messaging: joseph.giancola.1@5919.direct.athenahealth.com

Organizations & group practices 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1265455539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 N TATUM BLVD",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281662",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 N TATUM BLVD",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281662",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANCOLA",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "21007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.