Active NPI
Az Dermatology LLC
- Dermatology Physician
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- AZ DERMATOLOGY LLC
- Practice address
- 4540 E Baseline Rd Ste 109
Mesa, AZ 85206-4616 - Phone
- (480) 982-3337
- Fax
- (520) 374-2467
- NPI assigned
- Feb 25, 2008
- Last updated
- Oct 2, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jayshri Gamoth, MD
- Title
- President
- Phone
- (480) 982-3337
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
4540 E Baseline Rd Ste 109
Mesa, AZ 85206-4616
Mailing address
4540 E Baseline Rd Ste 109
Mesa, AZ 85206-4616
Phone (480) 982-3337
Other practice location 1
10503 W Thunderbird Blvd Ste 114
Sun City, AZ 85351-3047
Phone (623) 466-8585
Other practice location 2
1343 N Alma School Rd # 135
Chandler, AZ 85224-5941
Phone (480) 982-3337
Other practice location 3
6724 S Kings Ranch Rd # 104
Gold Canyon, AZ 85118-2962
Phone (480) 982-3337
Other practice location 4
1821 N Trekell Rd
Ste 7
Casa Grande, AZ 85122-1705
Phone (520) 374-2462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080317000520 | AZ | Part B Supplier - Clinic/Group Practice | 5698850543 |
Receives reassigned benefits from 29 practitioners 3 other NPIs on this enrollment Practice locations: Casa Grande, AZ; Sun City, AZ; Mesa, AZ; Gold Canyon, AZ; Chandler, AZ |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
1876 E Sabin Dr
Bldg B
Casa Grande, AZ 85122
Phone (480) 982-3337
1343 N Alma School Rd
#135
Chandler, AZ 85224
Phone (480) 982-3337
3930 S Alma School Rd
Ste B
Chandler, AZ 85248
Phone (480) 982-3337
959 N McQueen Rd
Chandler, AZ 85225
Phone (480) 982-3337
6724 S Kings Ranch Rd
#104
Gold Canyon, AZ 85118
Phone (480) 982-3337
6788 S Kings Ranch Rd
#23
Gold Canyon, AZ 85118
6788 S Kings Ranch Rd
Ste 104
Gold Canyon, AZ 85118
6788 S Kings Ranch Rd
Ste 2
Gold Canyon, AZ 85118
6788 S Kings Ranch Rd
Ste 23
Gold Canyon, AZ 85118
6788 S Kings Ranch Rd
Ste 3
Gold Canyon, AZ 85118
4540 E Baseline Rd
Mesa, AZ 85206
Phone (480) 545-9611
10503 W Thunderbird Blvd
Ste 114
Sun City, AZ 85351
Phone (623) 466-8585
13650 N 99th Ave
Ste 100
Sun City, AZ 85351
13650 N 99th Ave
Ste 101
Sun City, AZ 85351
15405 N 99th Ave
Sun City, AZ 85351
Phone (623) 977-9000
1025 W 24th St
Ste 5
Yuma, AZ 85364
Phone (520) 374-2462
Practitioners & affiliated clinicians
Practitioners 29
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Dermatology Physician
- Mesa, AZ
- NPI 1851340467
-
- Physician Assistant
- Casa Grande, AZ
- NPI 1356329379
-
- Dermatology Physician
- Oro Valley, AZ
- NPI 1689087348
-
- Dermatology Physician
- Peoria, AZ
- NPI 1336341650
-
- Dermatology Physician
- Phoenix, AZ
- NPI 1952793408
-
- Medical Physician Assistant
- Mesa, AZ
- NPI 1962986349
-
- Family Nurse Practitioner
- Phoenix, AZ
- NPI 1568160653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601596800000",
"number": "1508035411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4540 E BASELINE RD STE 109",
"city": "MESA",
"state": "AZ",
"postal_code": "852064616",
"telephone_number": "480-982-3337",
"fax_number": "480-497-4580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4540 E BASELINE RD STE 109",
"city": "MESA",
"state": "AZ",
"postal_code": "852064616",
"telephone_number": "480-982-3337",
"fax_number": "520-374-2467"
}
],
"practiceLocations": [
{
"address_1": "10503 W Thunderbird Blvd Ste 114",
"address_purpose": "LOCATION",
"city": "Sun City",
"state": "AZ",
"postal_code": "853513047",
"country_code": "US",
"telephone_number": "623-466-8585",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1343 N Alma School Rd # 135",
"address_purpose": "LOCATION",
"city": "Chandler",
"state": "AZ",
"postal_code": "852245941",
"country_code": "US",
"telephone_number": "480-982-3337",
"fax_number": "480-497-4580",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6724 S Kings Ranch Rd # 104",
"address_purpose": "LOCATION",
"city": "Gold Canyon",
"state": "AZ",
"postal_code": "851182962",
"country_code": "US",
"telephone_number": "480-982-3337",
"fax_number": "480-497-4580",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1821 N Trekell Rd",
"address_2": "Ste 7",
"address_purpose": "LOCATION",
"city": "Casa Grande",
"state": "AZ",
"postal_code": "851221705",
"country_code": "US",
"telephone_number": "520-374-2462",
"fax_number": "520-374-2467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "AZ DERMATOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-25",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A",
"authorized_official_last_name": "GAMOTH",
"authorized_official_first_name": "JAYSHRI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "480-982-3337",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.