OMNI DERMATOLOGY INCORPORATED
NPI 1003082090
Dermatology in Glendale, AZ

Active since April 30, 2008CLIA 03D2092598 · Certificate of Compliance
11851 N 51ST AVE STE E130, GLENDALE, AZ 85304(480) 954-3919(480) 954-3670 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Omni Dermatology Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMNI DERMATOLOGY INCORPORATED (NPI 1003082090) is a healthcare organization registered as a dermatology in Glendale, Arizona and active in the NPI registry since April 2008. The organization holds a CLIA Certificate of Compliance certificate valid through November 7, 2027 and lists Andrew J Racette, President, as its authorized official.

NPPES Registry Identity

NPI1003082090
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameOMNI DERMATOLOGY INCORPORATED
Location Address11851 N 51ST AVE STE E130Glendale, AZ 85304-2843
Mailing Address11851 N 51st Ave Ste E130Glendale, AZ 85304-2843 · (236) 299-9540
Fax(480) 954-3670
Organization SubpartNo
Authorized OfficialAndrew J RacettePresident · (602) 369-3634
Enumeration DateApril 30, 2008
Last NPPES UpdateApril 3, 2024
NPPES CertifiedApril 3, 2024
NPI 1003082090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in AZ · 4311
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
11851 N 51ST AVE STE E130, Glendale, AZ 85304

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 03D2092598

Omni Dermatology, Inc · Glendale, AZ
Active · expires Nov 7, 2027
CLIA Number03D2092598
Laboratory TypePhysician Office
Certificate Effective DateNovember 8, 2025
Certificate Expiration DateNovember 7, 2027
Laboratory DirectorAndrew J. Racette
Laboratory Phone(623) 299-9540
Laboratory LocationOmni Dermatology, Inc11851 N 51st Ave Ste E130, Glendale, AZ 85304
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
11851 N 51ST AVE STE E130
GLENDALE, AZ 85304
Nurse Practitioner (Family)
11851 N 51ST AVE STE E130
GLENDALE, AZ 85304
Dermatology
11851 N 51ST AVE STE E130
GLENDALE, AZ 85304
Dermatology
11851 N 51ST AVE STE E130
GLENDALE, AZ 85304

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omni Dermatology Incorporated's NPI number?

The NPI number for Omni Dermatology Incorporated is 1003082090. It was assigned to this organization in the NPPES registry on April 30, 2008.

Where is Omni Dermatology Incorporated located?

Omni Dermatology Incorporated is located at 11851 N 51st Ave Ste E130, Glendale, AZ 85304. The listed phone number is (480) 954-3919.

What is Omni Dermatology Incorporated's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Omni Dermatology Incorporated hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 03D2092598) is associated with this NPI, valid through November 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Omni Dermatology Incorporated accept?

Health plans from Ambetter from Arizona Complete Health and Imperial Insurance Companies, Inc. list Omni Dermatology Incorporated as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Omni Dermatology Incorporated was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.