Phoenix Skin II PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PHOENIX SKIN II PC

Doing business as

Phoenix Skin Medical Surgical Group

Practice address

5056 N Central Ave
Phoenix, AZ 85012-1521

Phone

(602) 222-9111

Fax

(602) 277-5111

NPI assigned

May 31, 2007

Last updated

Dec 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lee P Laris, DONPI 1649274671

Title

Physician

Phone

(602) 222-9111

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Skin Medical Surgical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 15

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.

• Lee P Laris, DO

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1649274671
  Medicare reassignment Care Compare group NPD Authorized official
• Ramona Kiani, DNP, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1861843765
  Medicare reassignment Care Compare group NPD
• Nichelle Madden, D.O.

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1952793408
  Medicare reassignment Care Compare group NPD
• Emily Shannon Sandahl, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1548146756
  Medicare reassignment Care Compare group NPD
• Alexia K Ford, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1215626601
  Medicare reassignment Care Compare group
• Teresa D Hunt, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1518389857
  Medicare reassignment Care Compare group
• Patrick Joseph Purves, PA

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1083216873
  Medicare reassignment Care Compare group
• Michael D Richards, PA

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1306840707
  Medicare reassignment Care Compare group
• Elizabeth Walter, PA

  • Medical Physician Assistant
  • Phoenix, AZ
  • NPI 1912280918
  Medicare reassignment Care Compare group
• Megan E Ahmed, FNP

  • Family Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1134678634
  Medicare reassignment NPD
• Katherine Azar Haworth, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1265573810
  Medicare reassignment
• Allison Nicole Lewis, PA-C

  • Dermatology Physician
  • San Diego, CA
  • NPI 1841915691

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1609078997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5056 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121521",
            "telephone_number": "602-222-9111",
            "fax_number": "602-277-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5056 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121521",
            "telephone_number": "602-222-9111",
            "fax_number": "602-277-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SKIN II PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "LARIS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "602-222-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Skin Medical Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Residential Reentry and Community Reintegration Resource Cente
• Phoenix Rheumatology Specialists
• Phoenix Rise Health and Wellness LLC
• Phoenix Rising of Arizona LLC
• Phoenix RN First Assistant LLC
• Phoenix Sleep Disorder Center Inc.
• Phoenix Sonographic Imaging
• Phoenix Spine Care, Inc.
• Phoenix Spine Consultants
• Phoenix Spine Consultants PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.