NPIMap

Organization Active NPI

HW Dermatology PLLC

  • Dermatology Physician
  • Mesa, AZ
National Provider Identifier
1750800033
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
006585 Issued in AZ
Legal business name
HW DERMATOLOGY PLLC
Practice address
10238 E Hampton Ave Ste 404
Mesa, AZ 85209-3319
Phone
(928) 532-7546
NPI assigned
Sep 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Jana Adams
Title
Practice Manager
Phone
(480) 276-7955

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 006585 AZ Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X 006585 AZ
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X 006585 AZ
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X 006585 AZ

Addresses

Primary practice location

10238 E Hampton Ave Ste 404
Mesa, AZ 85209-3319

Mailing address

5300 S Sutter Dr Ste 1
Show Low, AZ 85901-8055
Phone (480) 276-7955

Other names 1

  • Sunrise Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120001906 AZ Part B Supplier - Clinic/Group Practice 4880951201 Receives reassigned benefits from 4 practitioners
Practice locations: Mesa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2141563HW Dermatology, PLLC10238 E Hampton Ave Ste 404, Mesa, AZ 85209ComplianceMar 12, 2027

National Provider Directory

National Provider Directory

Locations

10238 E Hampton Ave
Ste 404
Mesa, AZ 85209
Phone (480) 771-7546

796 S 20th Ave
Thatcher, AZ 85552
Phone (928) 424-7546

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1750800033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR STE 1",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018055",
            "telephone_number": "480-276-7955",
            "fax_number": "928-532-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE STE 404",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093319",
            "telephone_number": "928-532-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HW DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "480-276-7955"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "006585",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "006585",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "AZ",
            "license": "006585",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "006585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.