PHOENIX SKIN MEDICAL SURGICAL GROUP - NPI 1609078997

Q: What is Phoenix Skin II PC's NPI number?

The NPI number for Phoenix Skin II PC is 1609078997. It was assigned to this organization in the NPPES registry on May 31, 2007. The provider is doing business as Phoenix Skin Medical Surgical Group.

Q: What is Phoenix Skin II PC's specialty?

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

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About Phoenix Skin Medical Surgical Group NPPES

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

PHOENIX SKIN MEDICAL SURGICAL GROUP (NPI 1609078997) is a healthcare organization registered as a dermatology in Phoenix, Arizona and active in the NPI registry since May 2007. The organization holds a CLIA Certificate of Compliance certificate valid through March 8, 2027 and lists Lee P Laris, Physician, as its authorized official.

NPPES Registry Identity

NPI1609078997

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NamePHOENIX SKIN II PC

Location Address5056 N CENTRAL AVEPhoenix, AZ 85012-1521

Mailing Address5056 N Central AvePhoenix, AZ 85012-1521 · (602) 222-9111 · Fax (602) 277-5111

Phone(602) 222-9111

Fax(602) 277-5111

Organization SubpartNo

Authorized OfficialLee P LarisPhysician · (602) 222-9111

Enumeration DateMay 31, 2007

Last NPPES UpdateDecember 12, 2023

NPPES CertifiedDecember 12, 2023

✔ NPI 1609078997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

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.

5056 N CENTRAL AVE, Phoenix, AZ 85012

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Other Names 1

Doing Business AsPhoenix Skin Medical Surgical Group

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.Insurance ›

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 03D2001285

Phoenix Skin Medical Surgical Group · Phoenix, AZ

Active · expires Mar 8, 2027

CLIA Number03D2001285

Laboratory TypePhysician Office

Certificate Effective DateMarch 9, 2025

Certificate Expiration DateMarch 8, 2027

Laboratory DirectorNichelle K. Madden

Laboratory Phone(602) 222-9111

Laboratory LocationPhoenix Skin Medical Surgical Group5056 N Central Avenue, Phoenix, AZ 85012

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.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICK JOSEPH PURVES PA

Physician Assistant