NPIMap

Organization Active NPI

All Dermatology, Inc.

  • Dermatopathology Physician
  • Glendale, AZ
National Provider Identifier
1578727947
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
ALL DERMATOLOGY, INC.
Practice address
6320A W Union Hills Dr
Suite 210
Glendale, AZ 85308-7177
Phone
(623) 376-7600
Fax
(623) 376-0229
NPI assigned
Jul 15, 2008
Last updated
Aug 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Authorized official

Name
Mr. James F Pehoushek, M.D.NPI 1104810720
Title
Physician/Owner
Phone
(623) 376-7600

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X
Allergy Physician 207KA0200X
Dermatology Physician 207N00000X
MOHS-Micrographic Surgery Physician 207ND0101X
Dermatopathology Physician 207ND0900X Primary
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X
Pediatric Dermatology Physician 207NP0225X
Procedural Dermatology Physician 207NS0135X

Addresses

Primary practice location

6320A W Union Hills Dr
Suite 210
Glendale, AZ 85308-7177

Mailing address

14239 W Bell Rd
Suite 101
Suprise, AZ 85374-2469
Phone (623) 544-7755

Other names 1

  • Allergy and Dermatology Specialists, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000757 AZ Part B Supplier - Clinic/Group Practice 4284527748 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendale, AZ; Surprise, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

6320 W Union Hills Dr
Ste 210
Glendale, AZ 85308

Practitioners & affiliated clinicians

Practitioners 8

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": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1578727947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "SUITE 101",
            "city": "SUPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-544-7755",
            "fax_number": "623-544-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320A W UNION HILLS DR",
            "address_2": "SUITE 210",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087177",
            "telephone_number": "623-376-7600",
            "fax_number": "623-376-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "PEHOUSHEK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "623-376-7600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allergy and Dermatology Specialists, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.