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SOUTHWEST SKIN SPECIALISTS LLC
NPI 1174521926
Dermatology in Phoenix, AZ

Active since July 13, 2005CLIA Certified · 2 labs
11130 N TATUM BLVD, SUITE 100, PHOENIX, AZ 85028(602) 494-1817(602) 494-7103 Get Directions Write a Review

NPPES record last updated: September 6, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southwest Skin Specialists Llc NPPES

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

SOUTHWEST SKIN SPECIALISTS LLC (NPI 1174521926) is a healthcare organization registered as a dermatology in Phoenix, Arizona and active in the NPI registry since July 2005. The organization holds 2 active CLIA laboratory certificates and lists Howard Jay Luber, President, as its authorized official.

NPPES Registry Identity

NPI1174521926
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOUTHWEST SKIN SPECIALISTS LLC
Location Address11130 N TATUM BLVD, SUITE 100Phoenix, AZ 85028-1630
Mailing Address10200 N 92nd St, #205Scottsdale, AZ 85258-4534 · (602) 494-1817 · Fax (602) 494-7103
Phone(602) 494-1817
Fax(602) 494-7103
Organization SubpartNo
Authorized OfficialHoward Jay LuberPresident · (602) 494-1817
Enumeration DateJuly 13, 2005
Last NPPES UpdateSeptember 6, 2017
✔ NPI 1174521926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in AZ · 98010735
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.
11130 N TATUM BLVD, Phoenix, AZ 85028
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Other Identifiers 1

Medicare PINZWMBJQAZ

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.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)

Southwest Skin Specialists Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

53

Medicare enrollment records show 53 clinicians reassign Medicare billing to Southwest Skin Specialists LLC, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 26 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Dermatology46
Pathology3
Micrographic Dermatologic Surgery (MDS)2
Nurse Practitioner1
Plastic and Reconstructive Surgery1

Nearest to this location (20)

See all 53
David Glembocki, MD
Pathology
NPI 1043288657
11130 N TATUM BLVD SUITE 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Benjamin Lesueur, MD
Dermatology
NPI 1356364624
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Howard Luber, MD
Dermatology
NPI 1679596530
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOSSame address
Neel Patel, MD
Dermatology
NPI 1629047345
11130 N TATUM BLVD STE. 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Julie Salmon, MD
Dermatology
NPI 1598788457
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOSSame address
Miriam Cummings, MD
Dermatology
NPI 1174546444
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Amanda Rainwater, MD
Dermatology
NPI 1083637359
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
James Foshee, MD
Dermatology
NPI 1689037152
11130 N TATUM BLVD STE 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Joseph Giancola, MD
Dermatology
NPI 1265455539
11130 N TATUM BLVD #100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Shannon Heck, M.D.
Dermatology
NPI 1992811947
11130 N TATUM BLVD SUITE 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Randi Rubenzik, MD
Dermatology
NPI 1588612964
11130 N TATUM BLVD STE 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Adam Luber, M.D.
Dermatology
NPI 1396155867
11130 N TATUM BLVD STE 100
Phoenix, AZ 85028
(602) 494-1817
✔ PECOS✔ Accepts MedicareSame address
Florencia Anatelli, MD
Pathology
NPI 1053408849
5010 E SHEA BLVD STE 130
Scottsdale, AZ 85254
(602) 494-1817
✔ PECOS✔ Accepts Medicare0.4 mi
Jennifer Sawaya, M.D.
Dermatology
NPI 1235544479
10900 N SCOTTSDALE RD STE 202
Scottsdale, AZ 85254
(602) 494-1817
✔ PECOS✔ Accepts Medicare3.0 mi
Jacqueline Watchmaker, M.D.
Dermatology
NPI 1033568761
10900 N SCOTTSDALE RD
Scottsdale, AZ 85254
(480) 210-1988
✔ PECOS✔ Accepts Medicare3.0 mi
Brigitte Sledge
Dermatology
NPI 1285139063
11333 N SCOTTSDALE RD STE 115
Scottsdale, AZ 85254
(480) 998-1400
✔ PECOS✔ Accepts Medicare3.1 mi
Diana Jimenez, FNP-C
Nurse Practitioner
NPI 1215509336
3229 E GREENWAY RD STE 102
Phoenix, AZ 85032
(602) 788-3285
✔ PECOS✔ Accepts Medicare3.3 mi
Samuel Devictor, MD
Plastic and Reconstructive Surgery
NPI 1619301884
8994 E DESERT COVE AVE
Scottsdale, AZ 85260
(480) 551-2040
✔ PECOS✔ Accepts Medicare5.3 mi
Christina Kranc, M.D.
Dermatology
NPI 1447505755
10200 N 92ND ST STE 205
Scottsdale, AZ 85258
(602) 494-1817
✔ PECOS✔ Accepts Medicare5.6 mi
Kimberly Yeung Yue, MD
Dermatology
NPI 1578776027
10200 N 92ND ST SUITE 205
Scottsdale, AZ 85258
(602) 494-1817
✔ PECOS✔ Accepts Medicare5.6 mi
See all 53 clinicians

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 2

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 03D0955419

Southwest Skin Specialists · Phoenix, AZ
Active · expires Aug 1, 2027
CLIA Number03D0955419
Laboratory TypePhysician Office
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorJoseph M. Giancola
Laboratory Phone(602) 494-1817
Laboratory LocationSouthwest Skin Specialists11130 N Tatum Blvd #i-100, Phoenix, AZ 85028
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 03D2150971

Southwest Skin Specialists - Us Derm Partners · Phoenix, AZ
Active · expires Jul 8, 2028
CLIA Number03D2150971
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2026
Certificate Expiration DateJuly 8, 2028
Laboratory DirectorHoward J. Luber
Laboratory Phone(602) 494-1817
Laboratory LocationSouthwest Skin Specialists - Us Derm Partners4400 N 32nd St, #140, Phoenix, AZ 85018
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Southwest Skin Specialists LLC's NPI number?

The NPI number for Southwest Skin Specialists LLC is 1174521926. It was assigned to this organization in the NPPES registry on July 13, 2005.

Where is Southwest Skin Specialists LLC located?

Southwest Skin Specialists LLC is located at 11130 N Tatum Blvd Suite 100, Phoenix, AZ 85028. The listed phone number is (602) 494-1817.

What is Southwest Skin Specialists LLC's specialty?

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

Is Southwest Skin Specialists LLC enrolled in Medicare?

Yes. Southwest Skin Specialists LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southwest Skin Specialists LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 53 clinicians in 5 Medicare specialties reassign their Medicare billing to Southwest Skin Specialists LLC. 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 (46), Pathology (3) and Micrographic Dermatologic Surgery (MDS) (2). Of these, 12 practice at this address and 26 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southwest Skin Specialists LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Southwest Skin Specialists LLC accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Southwest Skin Specialists LLC 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 Southwest Skin Specialists LLC was last updated on September 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.