Individual provider Active NPI

Glenn H Brown, M.D.

  • Procedural Dermatology Physician
  • Mesa, AZ
National Provider Identifier
1780653030
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
14201 Issued in AZ
Practice address
1450 S Dobson Rd
#320B
Mesa, AZ 85202-4712
Phone
(480) 835-9755
Fax
(480) 964-8668
NPI assigned
Mar 17, 2006
Last updated
Dec 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 14201 AZ Primary

Addresses

Primary practice location

1450 S Dobson Rd
#320B
Mesa, AZ 85202-4712

Mailing address

1450 S Dobson Rd
#320B
Mesa, AZ 85202-4712
Phone (480) 835-9755

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
I20040331000926 AZ Practitioner - Dermatology 4082606371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Care Specialists PLLCGroup PAC ID 7315286044, 11 clinicians

Practice addresses (Care Compare)

6832 E Brown Rd
Mesa, AZ 85207-3755
Phone (480) 830-8333

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision39
Removal of skin lesions1867
Removal or shaving of skin growth1-10
Skin biopsy760

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14201AZMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Care Specialists PLLC Dermatology CurrentSince Jan 1, 2024 Accepting new patients

Locations

1450 S Dobson Rd
Ste 320B
Mesa, AZ 85202
Phone (480) 830-8333

6832 E Brown Rd
Mesa, AZ 85207
Phone (480) 830-8333

Interoperability endpoints

  • Direct secure messaging: browng@skincarespecialists.emadirect.md

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1780653030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD",
            "address_2": "#320B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024712",
            "telephone_number": "480-835-9755",
            "fax_number": "480-964-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD",
            "address_2": "#320B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024712",
            "telephone_number": "480-835-9755",
            "fax_number": "480-964-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GLENN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "14201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.