Theresa T Magne, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

23281 Issued in AZ

Practice address

14155 N 83Rd Ave
Suite @110
Peoria, AZ 85381-5639

Phone

(623) 215-0911

Fax

(623) 215-0912

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926
  Medicare reassignment NPD
• Southwest Skin Specialists, LLC

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1609185347
  NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1417974403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE",
            "address_2": "SUITE #110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-215-0911",
            "fax_number": "623-215-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE",
            "address_2": "SUITE @110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-215-0911",
            "fax_number": "623-215-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNE",
        "first_name": "THERESA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "23281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Madsen
• Magellan Health Services of Arizona, Inc.
• Roger Anthony Magga, RPH
• Maggio Performance and Therapy
• Daniel Maggio, PT, DPT
• Andrea Christian Magness, M.ED
• Magnify LLC
• Mindy Rose Magoon
• Gretchen A Magsam, PHARMD
• Arvind Mahadevan, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.