MIRAGE DERMATOLOGY MEDICAL ASSOCIATES, INC.
NPI 1346262375
Clinic/Center - Medical Specialty in Palm Desert, CA

NPI Status: Active since July 25, 2006

Contact Information

36867 COOK ST
SUITE 101
PALM DESERT, CA
ZIP 92211
Phone: (760) 341-1999
Fax: (760) 341-1997

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  • Organization
  • Clinic/Center
  • Medical Specialty
  • CLIA Number: 05D0930533
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-30-2025

About MIRAGE DERMATOLOGY MEDICAL ASSOCIATES, INC.

This page provides the complete NPI Profile along with additional information for Mirage Dermatology Medical Associates, Inc., a provider established in Palm Desert, California operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1346262375 assigned on July 2006. The practitioner's primary taxonomy code is 261QM2500X with license number G53073 (CA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Mirage Dermatology Medical Associates, Inc.. The authorized official of this NPI record is Dr. Timothy Richardson M.d. (President)

NPI
1346262375
Provider Legal Name
TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION
Other Organization Name
MIRAGE DERMATOLOGY MEDICAL ASSOCIATES, INC.
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
36867 COOK ST SUITE 101 PALM DESERT, CA 92211
Location Phone
(760) 341-1999
Location Fax
(760) 341-1997
Mailing Address
PO BOX 1486 RANCHO MIRAGE, CA 92270
Mailing Phone
(760) 341-1999
Mailing Fax
(760) 341-1997
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-25-2006
Last Update Date
06-28-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Medical Specialty

Taxonomy Code
261QM2500X
Type
Ambulatory Health Care Facilities
License No.
G53073
License State
CA
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. TIMOTHY RICHARDSON M.D.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(760) 341-1999

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
ZZZ23174ZOTHER (01)CAMEDICARE PTAN

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0930533
Facility Type
Physician Office
Certificate Effective Date
October 23, 2022
Certificate Expiration Date
September 30, 2025
Laboratory Director
TIMOTHY F. RICHARDSON
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Mirage Dermatology Medical Associates, Inc. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1346262375, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
4
Doubled → 8
Pos 4
6
Unchanged
Pos 5
2
Doubled → 4
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
3
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 2 → 4 2 → 4 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 8 + 6 + 4 + 6 + 4 + 3 + 1 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1346262375.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Otolaryngology
36867 COOK ST, SUITE 103
PALM DESERT, CA 92211
Nurse Practitioner
36867 COOK ST, SUITE 101
PALM DESERT, CA 92211
Otolaryngology
36867 COOK ST, SUITE 103
PALM DESERT, CA 92211
Dermatology (MOHS-Micrographic Surgery)
36867 COOK ST, SUITE 101
PALM DESERT, CA 92211

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346262375, enumerated as an "organization" on July 25, 2006.

The provider is located at 36867 COOK ST SUITE 101 PALM DESERT, CA 92211 and the phone number is (760) 341-1999.

Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.