Active NPI
Jay Victor, M.D.
- Dermatology Physician
- Scottsdale, AZ
National Provider Identifier
1720112436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 25475
- Practice address
- 9280 E Thompson Peak Pkwy Unit 28
Scottsdale, AZ 85255-4521 - Phone
- (248) 563-1216
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 25475 | MI | Primary |
Addresses
Primary practice location
9280 E Thompson Peak Pkwy Unit 28
Scottsdale, AZ 85255-4521
Mailing address
9280 E Thompson Peak Pkwy Unit 28
Scottsdale, AZ 85255-4521
Phone (248) 563-1216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25475 | MI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1720112436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9280 E THOMPSON PEAK PKWY UNIT 28",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852554521",
"telephone_number": "248-563-1216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9280 E THOMPSON PEAK PKWY UNIT 28",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852554521",
"telephone_number": "248-563-1216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICTOR",
"first_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "25475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.