PHOENIX SKIN MEDICAL SURGICAL GROUP
NPI 1609078997
Dermatology in Phoenix, AZ

NPI Status: Active since May 31, 2007

Contact Information

5056 N CENTRAL AVE
PHOENIX, AZ
ZIP 85012
Phone: (602) 222-9111
Fax: (602) 277-5111

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Dermatology
Accepts Insurance
CLIA Number: 03D2001285
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 06-30-2025

About PHOENIX SKIN MEDICAL SURGICAL GROUP

This page provides the complete NPI Profile along with additional information for Phoenix Skin Medical Surgical Group, a provider established in Phoenix, Arizona operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1609078997 assigned on May 2007. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Phoenix Skin Medical Surgical Group. The authorized official of this NPI record is Dr. Lee P Laris Do (Physician)

NPI: 1609078997
Provider Legal Name: PHOENIX SKIN II PC
Other Organization Name: PHOENIX SKIN MEDICAL SURGICAL GROUP
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 5056 N CENTRAL AVE PHOENIX, AZ 85012
Location Phone: (602) 222-9111
Location Fax: (602) 277-5111
Mailing Address: 5056 N CENTRAL AVE PHOENIX, AZ 85012
Mailing Phone: (602) 222-9111
Mailing Fax: (602) 277-5111
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 05-31-2007
Last Update Date: 12-12-2023
Code Navigator

A dermatologist like Phoenix Skin Medical Surgical Group is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

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: Dermatology
Taxonomy Code: 207N00000X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: 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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

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

Ambetter from Arizona Complete Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Clear Silver - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Silver - HMO
Complete Silver + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Gold - HMO
Standard Gold + Vision + Adult Dental - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Imperial Insurance Companies, Inc.

Imperial Preferred Gold - HMO
Imperial Preferred Silver - HMO
Imperial Standard Bronze - HMO
Imperial Standard Gold - HMO
Imperial Standard Silver - HMO

*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. LEE P LARIS DO
Authorized Official Title: PHYSICIAN
Authorized Official Phone: (602) 222-9111

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: 03D2001285
Facility Type: Physician Office
Certificate Effective Date: March 09, 2023
Certificate Expiration Date: June 30, 2025
Laboratory Director: NICHELLE K. MADDEN
Certificate Type: Certificate of Compliance
Certificate Type Description: This CLIA certificate is issued to Phoenix Skin Medical Surgical Group 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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	6	0	9	0	7	8	9	9	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	6	0	9	0	7	16	9	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 0 + 7 + 1 + 6 + 9 + 1 + 8 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 7									7

The NPI number 1609078997 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.