OMNI DERMATOLOGY INCORPORATED
NPI 1003082090
Dermatology in Glendale, AZ
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
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Omni Dermatology Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Omni Dermatology Incorporated, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (15)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, AZFrequently 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.
Is Omni Dermatology Incorporated enrolled in Medicare?
Yes. Omni Dermatology Incorporated is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Omni Dermatology Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 4 Medicare specialties reassign their Medicare billing to Omni Dermatology Incorporated. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (7), Nurse Practitioner (6) and General Practice (1). Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Cigna HealthCare of Arizona, Inc 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.
# Omni Dermatology Incorporated · NPI 1003082090
Dermatology organization in Glendale, Arizona. Organization record, active in the CMS NPPES registry since April 30, 2008.
## Identity
- **NPI:** 1003082090 (Entity type: Organization)
- **Enumerated:** April 30, 2008
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Andrew Racette, PRESIDENT
## Practice location
- **Address:** 11851 N 51ST AVE STE E130, Glendale, AZ 85304-2843
- **Phone:** (480) 954-3919 · **Fax:** (480) 954-3670
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 15 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (7), Nurse Practitioner (6), General Practice (1); 3 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 3, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003082090) · Data from the CMS NPPES public registry.