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PHOENIX SURGICAL DERMATOLOGY GROUP LLC
NPI 1447884929
Dermatology - MOHS-Micrographic Surgery in Phoenix, AZ

Active since February 24, 2020CLIA 03D2181402 · Certificate of Compliance
4550 E BELL RD BLDG 5, PHOENIX, AZ 85032(480) 666-5568(702) 297-6238 Get Directions Write a Review

NPPES record last updated: February 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Phoenix Surgical Dermatology Group Llc NPPES

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

PHOENIX SURGICAL DERMATOLOGY GROUP LLC (NPI 1447884929) is a healthcare organization registered as a mohs-micrographic surgery in Phoenix, Arizona and active in the NPI registry since February 2020. The organization holds a CLIA Certificate of Compliance certificate valid through September 20, 2028 and lists Ramin Fathi, Owner, as its authorized official.

NPPES Registry Identity

NPI1447884929
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NamePHOENIX SURGICAL DERMATOLOGY GROUP LLC
Location Address4550 E BELL RD BLDG 5Phoenix, AZ 85032-9390
Mailing Address4550 E Bell Rd Bldg 5Phoenix, AZ 85032-9390 · (480) 666-5568 · Fax (702) 297-6238
Phone(480) 666-5568
Fax(702) 297-6238
Organization SubpartNo
Authorized OfficialRamin FathiOwner · (480) 666-5568
Enumeration DateFebruary 24, 2020
Last NPPES UpdateFebruary 29, 2020
✔ NPI 1447884929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
4550 E BELL RD BLDG 5, Phoenix, AZ 85032
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phoenix Surgical Dermatology Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Phoenix Surgical Dermatology Group LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Colleen Luna, MD
Dermatology
NPI 1861072654
4550 E BELL RD BLDG 5
Phoenix, AZ 85032
(480) 666-5568
✔ PECOS✔ Accepts Medicare0.1 mi
Brent Sloten, DO
Dermatology
NPI 1073585402
4550 E BELL RD BLDG 5
Phoenix, AZ 85032
(480) 666-5568
✔ PECOS✔ Accepts Medicare0.1 mi
Ramin Fathi, MD
Dermatology
NPI 1215374186
13400 E SHEA BLVD
Scottsdale, AZ 85259
(480) 301-8000
✔ PECOS✔ Accepts Medicare12 mi

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 03D2181402

Phoenix Surgical Dermatology Group, LLC · Phoenix, AZ
Active · expires Sep 20, 2028
CLIA Number03D2181402
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2026
Certificate Expiration DateSeptember 20, 2028
Laboratory DirectorRamin Fathi
Laboratory Phone(480) 666-5568
Laboratory LocationPhoenix Surgical Dermatology Group, LLC4550 E Bell Rd Ste 150, Phoenix, AZ 85032
CLIA data matches this NPI record on: 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.

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 Phoenix Surgical Dermatology Group LLC's NPI number?

The NPI number for Phoenix Surgical Dermatology Group LLC is 1447884929. It was assigned to this organization in the NPPES registry on February 24, 2020.

Where is Phoenix Surgical Dermatology Group LLC located?

Phoenix Surgical Dermatology Group LLC is located at 4550 E Bell Rd Bldg 5, Phoenix, AZ 85032. The listed phone number is (480) 666-5568.

What is Phoenix Surgical Dermatology Group LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Phoenix Surgical Dermatology Group LLC enrolled in Medicare?

Yes. Phoenix Surgical Dermatology Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Phoenix Surgical Dermatology Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Phoenix Surgical Dermatology Group 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Phoenix Surgical Dermatology Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 03D2181402) is associated with this NPI, valid through September 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Phoenix Surgical Dermatology Group LLC was last updated on February 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.