Scottsdale Skin Boutique and Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SCOTTSDALE SKIN BOUTIQUE AND DERMATOLOGY PLLC

Practice address

11333 N Scottsdale Rd Ste 115
Scottsdale, AZ 85254-5186

Phone

(310) 980-7532

NPI assigned

Nov 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Genevieve Egnatios, MDNPI 1164683793

Title

Physician

Phone

(480) 998-1400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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

• Genevieve L Egnatios, M.D.

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1164683793
  Medicare reassignment Care Compare group NPD Authorized official
• Kiilani Kristen Lois Buczkowski, NP-C

  • Family Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1265861041
  Medicare reassignment Care Compare group NPD
• Emily Ann Schlinz, NP-C

  • Family Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1205345139

  Dermatology

  Medicare reassignment Care Compare group NPD
• Heidi Elizabeth Kipers Mullen, D.O.

  • Dermatology Physician
  • Exeter, NH
  • NPI 1851827588

  AZ

  Medicare reassignment Care Compare group NPD
• Brigitte Sledge

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1285139063

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1605398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1801498704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11333 N SCOTTSDALE RD STE 115",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545186",
            "telephone_number": "480-998-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 N SCOTTSDALE RD STE 115",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545186",
            "telephone_number": "310-980-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE SKIN BOUTIQUE AND DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-15",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "EGNATIOS",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-998-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.