NPIMap

Organization Active NPI

DMC Dermatology & Mohs

Doing business as DMC Dermatology

  • Dermatology Physician
  • Tucson, AZ
National Provider Identifier
1467047274
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DMC DERMATOLOGY & MOHS
Doing business as
DMC Dermatology
Practice address
4715 E Camp Lowell Dr
Tucson, AZ 85712-1256
Phone
(520) 955-8395
Fax
(520) 300-8013
NPI assigned
Mar 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Amy Chabra, JD
Title
Coo
Phone
(520) 955-8395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4715 E Camp Lowell Dr
Tucson, AZ 85712-1256

Mailing address

4715 E Camp Lowell Dr
Tucson, AZ 85712-1256
Phone (520) 955-8395

Other practice location 1

MHC Healthcare Marana Main Health Center
13395 N Marana Main St
Marana, AZ 85653-8565
Phone (520) 433-7000

Other practice location 2

450 S Ocotillo Ave
Benson, AZ 85602-6403
Phone (520) 955-8395

Other practice location 3

63675 East Saddlebrooke Boulevard
Tucson, AZ 85739-1297
Phone (520) 955-8395

Other practice location 4

10350 E Drexel Road
Suite 204
Tucson, AZ 85747-9405
Phone (520) 955-8395

Other names 1

  • DMC Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210506001749 AZ Part B Supplier - Clinic/Group Practice 3274942032 Receives reassigned benefits from 6 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

4455 S I 19 Frontage Rd
#225
Green Valley, AZ 85614

10042 E Old Vail Rd
Tucson, AZ 85747
Phone (520) 433-7000

395 N Silverbell Rd
Tucson, AZ 85745
Phone (520) 622-5912

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1467047274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 E CAMP LOWELL DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121256",
            "telephone_number": "520-955-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 E CAMP LOWELL DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121256",
            "telephone_number": "520-955-8395",
            "fax_number": "520-300-8013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MHC Healthcare Marana Main Health Center",
            "address_2": "13395 N Marana Main St",
            "address_purpose": "LOCATION",
            "city": "Marana",
            "state": "AZ",
            "postal_code": "856538565",
            "country_code": "US",
            "telephone_number": "520-433-7000",
            "fax_number": "520-300-8013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 S Ocotillo Ave",
            "address_purpose": "LOCATION",
            "city": "Benson",
            "state": "AZ",
            "postal_code": "856026403",
            "country_code": "US",
            "telephone_number": "520-955-8395",
            "fax_number": "520-300-8013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "63675 East Saddlebrooke Boulevard",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857391297",
            "country_code": "US",
            "telephone_number": "520-955-8395",
            "fax_number": "520-300-8013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 E Drexel Road",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857479405",
            "country_code": "US",
            "telephone_number": "520-955-8395",
            "fax_number": "520-300-8013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DMC DERMATOLOGY & MOHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "CHABRA",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "520-955-8395",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMC Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DMC Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.