DESERT DERMATOLOGY, PLLC
NPI 1417673112
Dermatology in Oro Valley, AZ
About Desert Dermatology, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DESERT DERMATOLOGY, PLLC (NPI 1417673112) is a healthcare organization registered as a dermatology in Oro Valley, Arizona and active in the NPI registry since October 2022. The organization holds a CLIA Certificate of Compliance certificate valid through March 6, 2027 and lists Michelle Goedken, Owner/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Desert Dermatology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Desert Dermatology, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 03D2272999
Desert Dermatology PLLC · Oro Valley, 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 Desert Dermatology, PLLC's NPI number?
The NPI number for Desert Dermatology, PLLC is 1417673112. It was assigned to this organization in the NPPES registry on October 13, 2022.
Where is Desert Dermatology, PLLC located?
Desert Dermatology, PLLC is located at 1521 E Tangerine Rd Ste 161, Oro Valley, AZ 85755. The listed phone number is (520) 771-0288.
What is Desert Dermatology, PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Desert Dermatology, PLLC enrolled in Medicare?
Yes. Desert Dermatology, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Desert Dermatology, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Desert Dermatology, PLLC, in Dermatology and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Desert Dermatology, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 03D2272999) is associated with this NPI, valid through March 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Desert Dermatology, PLLC was last updated on October 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Desert Dermatology, Pllc · NPI 1417673112
Dermatology organization in Oro Valley, Arizona. Organization record, active in the CMS NPPES registry since October 13, 2022.
## Identity
- **NPI:** 1417673112 (Entity type: Organization)
- **Enumerated:** October 13, 2022
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Michelle Goedken, OWNER/PHYSICIAN
## Practice location
- **Address:** 1521 E TANGERINE RD STE 161, Oro Valley, AZ 85755-6217
- **Phone:** (520) 771-0288 · **Fax:** (520) 771-0289
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 13, 2022
- **Other identifiers:** Medicaid 110342 (AZ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417673112) · Data from the CMS NPPES public registry.