Southwest Skin Specialists, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

98010735 Issued in AZ

Legal business name

SOUTHWEST SKIN SPECIALISTS, LLC

Practice address

5010 E Shea Blvd Ste 130
Scottsdale, AZ 85254-4709

Phone

(602) 494-1817

Fax

(602) 494-7103

NPI assigned

Sep 29, 2010

Organization subpart

No

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

Authorized official

Name

Howard J. Luber, M.D.NPI 1679596530

Title

Medical Director

Phone

(602) 494-1817

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwest Skin Specialists, LTD / Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926

  O20040319001063

  Same enrollment

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

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Beatrice Keller Clinic, PC

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1467402933

  Member Of

  NPD member

Locations

Practitioners 53

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

• Howard Jay Luber, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1679596530
  NPD Authorized official
• Lindsay Skye Ackerman, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609900299
  NPD
• Florencia Anatelli, MD

  • Dermatopathology (Pathology) Physician
  • Scottsdale, AZ
  • NPI 1053408849
  NPD
• Katharine M Bermingham Cordova, MD

  • MOHS-Micrographic Surgery Physician
  • Sun City West, AZ
  • NPI 1396962767
  NPD
• Rachel Lauren Cetta, DO

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1942681655
  NPD
• Miriam Paulette Cummings, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174546444
  NPD
• Samuel Devictor, MD

  • Facial Plastic Surgery Physician
  • Scottsdale, AZ
  • NPI 1619301884
  NPD
• Melissa F Efron-Everett, M.D.

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1588956361
  NPD
• Troy C Ellis, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1356491997
  NPD
• Jennifer Fernandez, MD

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1972182939
  NPD
• James Patrick Foshee, MD

  • MOHS-Micrographic Surgery Physician
  • Phoenix, AZ
  • NPI 1689037152
  NPD
• Mary F Fredenberg, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1134140999
  NPD

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1609185347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 N TATUM BLVD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281662",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 E SHEA BLVD STE 130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544709",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SKIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "LUBER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "602-494-1817",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "98010735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "WMBJQ",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Skin Specialists, LTD /",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southwest Multicare II
• Southwest Parathyroid Center PLLC
• Southwest Pediatric Endocrinology, PLC
• Southwest Rehabilitation Care PLLC
• Southwest Renal Care LLC
• Southwest Sleep Centers LLC
• Southwest Spine & Sports PC
• Southwest Spine Center
• Southwest Sports Medicine & Orthopaedic Surgery Clinic, LTD.
• Southwest TMS Center LLC

• Clinical Medical Laboratory in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Clinical Medical Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.