Luminary Dermatology, PA

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

LUMINARY DERMATOLOGY, PA

Practice address

2101 61St St W
Bradenton, FL 34209-5528

Phone

(941) 926-6553

NPI assigned

Apr 24, 2019

Last updated

Jan 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jessica Lynn Phillips

Title

Ceo

Phone

(941) 302-4669

Specialties & licenses 10

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yuleidy Andarcio Lujan, APRN

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1447892179
  Medicare reassignment Care Compare group NPD
• Brett Christopher Brazen, DO

  • Dermatology Physician
  • Aventura, FL
  • NPI 1770169328
  Medicare reassignment Care Compare group NPD
• Janet M Delaney, ARNP

  • Nurse Practitioner
  • Bradenton, FL
  • NPI 1407811086
  Medicare reassignment Care Compare group NPD
• Michael Gregory Foss

  • Dermatology Physician
  • Bradenton, FL
  • NPI 1285193193
  Medicare reassignment Care Compare group NPD
• Nadia Hogan

  • Family Nurse Practitioner
  • Bradenton, FL
  • NPI 1104612704
  Medicare reassignment Care Compare group NPD
• Michael Jerry Randolph, MD

  • Dermatology Physician
  • Miami, FL
  • NPI 1780263830
  Medicare reassignment Care Compare group NPD
• Joseph F Seber, M.D.

  • Dermatology Physician
  • North Miami Beach, FL
  • NPI 1558326215

  Specialist

  Medicare reassignment Care Compare group NPD
• Phyllis Skolnik, M.D.

  • Procedural Dermatology Physician
  • Miami, FL
  • NPI 1023081692
  Medicare reassignment Care Compare group NPD
• Ashley Llera, PA

  • Physician Assistant
  • North Miami Beach, FL
  • NPI 1780184853
  Medicare reassignment Care Compare group
• Cary L Dunn, M.D.

  • Dermatology Physician
  • Mobile, AL
  • NPI 1639163298

  FL

  Medicare reassignment NPD
• Karen L Maloney, MD

  • Dermatology Physician
  • St Charles, IL
  • NPI 1912918186

  FL

  Medicare reassignment NPD
• Eric W Bussear, P.A.

  • Physician Assistant
  • Miami, FL
  • NPI 1336160258
  Medicare reassignment

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1851955983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 BEE RIDGE RD",
            "address_2": "PMB 309",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332514",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095528",
            "telephone_number": "941-926-6553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8740 N Kendall Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762209",
            "country_code": "US",
            "telephone_number": "305-661-8978",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 NE 30th Ter Ste 308",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330337614",
            "country_code": "US",
            "telephone_number": "786-670-9799",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16870 NE 19th Ave",
            "address_purpose": "LOCATION",
            "city": "North Miami Beach",
            "state": "FL",
            "postal_code": "331623108",
            "country_code": "US",
            "telephone_number": "305-947-1466",
            "fax_number": "305-944-0692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "819 N Mills Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668716",
            "country_code": "US",
            "telephone_number": "863-491-2390",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 Bay Isles Rd",
            "address_purpose": "LOCATION",
            "city": "Longboat Key",
            "state": "FL",
            "postal_code": "342283129",
            "country_code": "US",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 E Venice Ave",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342921661",
            "country_code": "US",
            "telephone_number": "941-667-9030",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Haverford Ave",
            "address_purpose": "LOCATION",
            "city": "Sun City Center",
            "state": "FL",
            "postal_code": "335735200",
            "country_code": "US",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2032 Hawthorne St",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392307",
            "country_code": "US",
            "telephone_number": "941-926-6553",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S Tamiami Trl Ste 304",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392221",
            "country_code": "US",
            "telephone_number": "941-263-2988",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3105 Bobcat Village Center Rd",
            "address_purpose": "LOCATION",
            "city": "North Port",
            "state": "FL",
            "postal_code": "342888974",
            "country_code": "US",
            "telephone_number": "941-271-0021",
            "fax_number": "941-296-8501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMINARY DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-302-4669",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "B8XVQ",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Lugo, CPT
• Consuelo Lule, APRN
• Jennifer Luli, BS
• Margaret W. Lum, M.S., CCC-SLP
• Erin Elizabeth Lumia, MS, OTR/L
• Nina A Lundberg, MD
• Espen Lundh, CRNA
• Lydia Lynn Lundquist, DO
• Lung Associates PA
• Lung Center PA

• MOHS-Micrographic Surgery Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.