Individual provider Active NPI

Betty A Hinderks Davis, MD

  • MOHS-Micrographic Surgery Physician
  • Surprise, AZ
National Provider Identifier
1417906280
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
33887 Issued in AZ
Practice address
14725 W Mountain View Blvd
Surprise, AZ 85374-2704
Phone
(623) 243-9077
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 33887 AZ Primary

Addresses

Primary practice location

14725 W Mountain View Blvd
Surprise, AZ 85374-2704

Mailing address

10240 W Indian School Rd Ste 115
Phoenix, AZ 85037-5905
Phone (623) 243-9077

Other practice location 1

14420 W Meeker Blvd
Ste 104
Sun City West, AZ 85375-5286
Phone (623) 583-5300

Other practice location 2

10240 W Indian School Rd Ste 115
Phoenix, AZ 85037-5905
Phone (623) 243-9077

Other identifiers 1

IdentifierTypeStateIssuer
055923MedicaidAZ

Other names 1

  • Betty A Davis Other name

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
I20050630000633 AZ Practitioner - Dermatology 3476441833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Regency Skin Institute PLLCGroup PAC ID 5193097665, 14 clinicians

Practice addresses (Care Compare)

10240 W Indian School Rd
Suite 115
Phoenix, AZ 85037-5905
Phone (623) 243-9077

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
100
Improvement activities
40
Cost
83.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal33
Melanoma (skin cancer) excision416
Removal of tissue13
Removal of skin lesions4058
Removal of skin cancer1323
Removal of nail tissue1-10
Removal or shaving of skin growth132
Skin biopsy1848

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regency Skin Institute PLLC Mohs-Micrographic Surgery CurrentSince Jun 1, 2017 Accepting new patients
Regency Reconstruction PLLC Past Accepting new patients
Skin Diagnostics Group, PC Past Accepting new patients

Locations

10240 W Indian School Rd
Ste 115
Phoenix, AZ 85037
Phone (623) 243-9077

14725 W Mountain View Blvd
Surprise, AZ 85374
Phone (623) 243-9077

14725 W Mountain View Blvd
#125
Surprise, AZ 85374

14869 W Bell Rd
Ste 103
Surprise, AZ 85374

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1417906280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375905",
            "telephone_number": "623-243-9077",
            "fax_number": "623-271-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14725 W MOUNTAIN VIEW BLVD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-243-9077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14420 W Meeker Blvd",
            "address_2": "Ste 104",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853755286",
            "country_code": "US",
            "telephone_number": "623-583-5300",
            "fax_number": "623-583-5301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10240 W Indian School Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850375905",
            "country_code": "US",
            "telephone_number": "623-243-9077",
            "fax_number": "623-271-9826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINDERKS DAVIS",
        "first_name": "BETTY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "33887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055923",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETTY",
            "last_name": "DAVIS",
            "middle_name": "A",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.