Organization Active NPI

La Peau Dermatology LLC

  • Procedural Dermatology Physician
  • Mesa, AZ
National Provider Identifier
1548634348
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
5010 Issued in AZ
Legal business name
LA PEAU DERMATOLOGY LLC
Practice address
5424 E Southern Ave
Suite 103
Mesa, AZ 85206-3621
Phone
(480) 396-2300
NPI assigned
Nov 17, 2015
Last updated
Jan 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Zainab Rashid, D.O.NPI 1992816664
Title
Physician/Owner
Phone
(623) 225-8155

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)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X 5010 AZ Primary

Addresses

Primary practice location

5424 E Southern Ave
Suite 103
Mesa, AZ 85206-3621

Mailing address

5424 E Southern Ave
Suite 103
Mesa, AZ 85206-3621
Phone (480) 396-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160331000289 AZ Part B Supplier - Clinic/Group Practice 6103123435 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

5424 E Southern Ave
Ste 103
Mesa, AZ 85206
Phone (480) 396-2300

6465 E Southern Ave
Ste 100
Mesa, AZ 85206
Phone (480) 396-2300

6465 E Southern Ave
Ste 101
Mesa, AZ 85206
Phone (480) 396-2300

3271 N Civic Center Plz
Ste 5
Scottsdale, AZ 85251
Phone (480) 481-9223

4619 Kenny Rd
Columbus, OH 43220

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1548634348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 E SOUTHERN AVE",
            "address_2": "SUITE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063621",
            "telephone_number": "480-396-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 E SOUTHERN AVE",
            "address_2": "SUITE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063621",
            "telephone_number": "480-396-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PEAU DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "RASHID",
        "authorized_official_first_name": "ZAINAB",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "623-225-8155",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "5010",
            "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 Jan 30, 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.

Verify at the official NPI Registry.