Clear Sky Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

006549 Issued in AZ

Legal business name

CLEAR SKY DERMATOLOGY LLC

Practice address

2620 N 140TH Ave Ste 103
Goodyear, AZ 85395-2437

Phone

(623) 219-4777

NPI assigned

Jul 25, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Svancara, DONPI 1083052872

Title

Owner/Physician

Phone

(623) 853-3762

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Lee Svancara, D.O.

  • MOHS-Micrographic Surgery Physician
  • Goodyear, AZ
  • NPI 1083052872

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Abby Baker, APRN, NP-C

  • Family Nurse Practitioner
  • Goodyear, AZ
  • NPI 1184187676
  Medicare reassignment Care Compare group NPD
• Tanner R Smith, PA

  • Physician Assistant
  • Goodyear, AZ
  • NPI 1477288801
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1306369996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17620 W COLUMBINE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853885623",
            "telephone_number": "623-853-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE STE 103",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "623-219-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR SKY DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "SVANCARA",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "623-853-3762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "006549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "006549",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Goodyear
• City of Hope Medical Group of Arizona LLC
• Sandra Kay Clark
• Derel Clayton, CRNA
• Gregory S Clayton
• Alexandra Cleveland, MS
• Mackenzie Clinger, PT
• Sara Murray Cloar, OTD
• Cloward Orthodontics PLLC
• Daniel Cloward, D.M.D.

• Dermatology Physician in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.