Individual provider Active NPI

Clay Garrett Forsberg, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1629251004
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
48754 Issued in AZ
Practice address
14275 N 87TH St
Suite 110
Scottsdale, AZ 85260-3696
Phone
(480) 905-8485
Fax
(480) 905-7274
NPI assigned
Dec 9, 2007
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 48754 AZ
Plastic and Reconstructive Surgery Physician 2086S0122X A121163 CA
Plastic and Reconstructive Surgery Physician 2086S0122X 48754 AZ Primary

Addresses

Primary practice location

14275 N 87TH St
Suite 110
Scottsdale, AZ 85260-3696

Mailing address

14275 N 87TH St
Suite 110
Scottsdale, AZ 85260-3696
Phone (480) 905-8485

Other identifiers 1

IdentifierTypeStateIssuer
GJ636AMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017001529 AZ Practitioner - Plastic and Reconstructive Surgery 1355598442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Rochester School of Medicine and Dentistry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

14275 N 87TH St
Suite 110
Scottsdale, AZ 85260-3696
Phone (480) 905-8485

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
82.26
Promoting interoperability
83
Improvement activities
40
Cost
76.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision771
Removal of tissue45
Removal of skin lesions1-10
Removal of skin cancer1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48754AZMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Dermatology, PLLC PastSince Sep 1, 2014 Accepting new patients
Clay Forsberg, MD, Inc. Plastic Surgery PastSince Jul 13, 2012 Accepting new patients
Camelback Dermatology & Skin Surgery, Inc PastSince Jul 1, 2003 Accepting new patients
Scottsdale Center for Sight, PLC Past Accepting new patients
Valley Anesthesiology Consultants, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: forsbergc@cfd.emadirect.md
  • Direct secure messaging: forsbergc@pdpaz.emadirect.md
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1629251004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 N 87TH ST",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603696",
            "telephone_number": "480-905-8485",
            "fax_number": "480-905-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14275 N 87TH ST",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603696",
            "telephone_number": "480-905-8485",
            "fax_number": "480-905-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSBERG",
        "first_name": "CLAY",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-09",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "48754",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A121163",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "48754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GJ636A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.