Individual provider Active NPI

Howard Jay Luber, MD

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1679596530
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17517 Issued in AZ
Practice address
11130 N Tatum Blvd
#100
Phoenix, AZ 85028
Phone
(602) 494-1817
Fax
(602) 494-7103
NPI assigned
Jul 25, 2006
Last updated
Nov 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17517 AZ Primary

Addresses

Primary practice location

11130 N Tatum Blvd
#100
Phoenix, AZ 85028

Mailing address

11130 N Tatum Blvd
#100
Phoenix, AZ 85028
Phone (602) 494-1817

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
I20040730000031 AZ Practitioner - Dermatology 4587643762 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17517AZMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin Specialists LLC Dermatology Current Accepting new patients
Southwest Skin Specialists, LLC CurrentSince Jan 1, 1982 Accepting new patients

Locations

11130 N Tatum Blvd
Ste 100
Phoenix, AZ 85028
Phone (602) 494-1817

1331 N 7th St
Ste 250
Phoenix, AZ 85006
Phone (602) 354-5770

4400 N 32nd St
Ste 140
Phoenix, AZ 85018
Phone (602) 254-1429

10200 N 92nd St
Ste 205
Scottsdale, AZ 85258
Phone (602) 494-1817

4845 E Thunderbird Rd
Ste 2
Scottsdale, AZ 85254
Phone (602) 494-1817

Organizations & group practices 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1679596530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 N TATUM BLVD",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85028",
            "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": "11130 N TATUM BLVD",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85028",
            "telephone_number": "602-494-1817",
            "fax_number": "602-494-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBER",
        "first_name": "HOWARD",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "17517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.