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DERMATOLOGY AND PLASTIC SURGERY OF ARIZONA LLC
NPI 1649611476
Dermatology - MOHS-Micrographic Surgery in Sierra Vista, AZ

Active since July 09, 2013CLIA Certified · 2 labs
150 S CORONADO DR STE 110, SIERRA VISTA, AZ 85635(520) 458-1787(520) 458-1519 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 8, 2025, Jul 26, 2023 (2 updates tracked since 2023).

About Dermatology And Plastic Surgery Of Arizona Llc NPPES

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

DERMATOLOGY AND PLASTIC SURGERY OF ARIZONA LLC (NPI 1649611476) is a healthcare organization registered as a mohs-micrographic surgery in Sierra Vista, Arizona and active in the NPI registry since July 2013. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Tucson, and lists Jamie M Moenster, Member, as its authorized official.

NPPES Registry Identity

NPI1649611476
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameDERMATOLOGY AND PLASTIC SURGERY OF ARIZONA LLC
Location Address150 S CORONADO DR STE 110Sierra Vista, AZ 85635-6352
Mailing Address150 S Coronado Dr Ste 110Sierra Vista, AZ 85635-6352 · (520) 458-1787 · Fax (520) 458-1519
Phone(520) 458-1787
Fax(520) 458-1519
Organization SubpartNo
Authorized OfficialJamie M MoensterMember · (520) 458-1787
Enumeration DateJuly 9, 2013
Last NPPES UpdateOctober 8, 20252 updates tracked since enumeration
NPPES CertifiedOctober 8, 2025
✔ NPI 1649611476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 · License 006021 (AZ)
Also ListedPlastic SurgeryTaxonomy 208200000X · License 006018 (AZ)
150 S CORONADO DR STE 110, Sierra Vista, AZ 85635
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Secondary Practice Location 1

Location 15101 N Oracle Rd # 121Tucson, AZ 85704-3713 · Phone (520) 207-3100 · Fax (520) 777-7634

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)

Dermatology And Plastic Surgery Of Arizona Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Dermatology And Plastic Surgery Of Arizona LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Geneva Daneker, FNP
Nurse Practitioner
NPI 1619419157
150 S CORONADO DR STE 110
Sierra Vista, AZ 85635
(520) 458-1787
✔ PECOS✔ Accepts MedicareSame address
Candy Mungarro-Rubio, FNP
Nurse Practitioner
NPI 1114697067
150 S CORONADO DR STE 110
Sierra Vista, AZ 85635
(520) 458-1787
✔ PECOS✔ Accepts MedicareSame address
Christopher Weyer, D.O.
Dermatology
NPI 1851515381
150 S CORONADO DR STE 110
Sierra Vista, AZ 85635
(520) 458-1787
✔ PECOS✔ Accepts MedicareSame address
Jessica Garnier
Nurse Practitioner
NPI 1760959118
2732 N ALVERNON WAY
Tucson, AZ 85712
(520) 382-3330
✔ PECOS✔ Accepts Medicare61 mi
Jamie Moenster, D.O.
Plastic and Reconstructive Surgery
NPI 1710189931
698 E WETMORE RD STE 310
Tucson, AZ 85705
(520) 207-3100
✔ PECOS✔ Accepts Medicare65 mi
Marco Swanson, MD
Plastic and Reconstructive Surgery
NPI 1386148047
698 E WETMORE RD STE 310
Tucson, AZ 85705
(520) 207-3100
✔ PECOS✔ Accepts Medicare65 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 2

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 03D2051228

Dermatology & Plastic Surgery Of Arizona · Sierra Vista, AZ
Active · expires Nov 25, 2027
CLIA Number03D2051228
Laboratory TypePhysician Office
Certificate Effective DateNovember 26, 2025
Certificate Expiration DateNovember 25, 2027
Laboratory DirectorChristopher W. Weyer
Laboratory Phone(520) 458-1787
Laboratory LocationDermatology & Plastic Surgery Of Arizona150 S Coronado Dr, Ste 110, Sierra Vista, AZ 85635
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 03D2054155

Dermatology & Plastic Surgery Of Arizona · Tucson, AZ
Active · expires Feb 25, 2027
CLIA Number03D2054155
Laboratory TypePhysician Office
Certificate Effective DateFebruary 26, 2025
Certificate Expiration DateFebruary 25, 2027
Laboratory DirectorChristopher W. Weyer
Laboratory Phone(520) 207-3100
Laboratory LocationDermatology & Plastic Surgery Of Arizona5101 N Oracle Rd Ste 121, Tucson, AZ 85704
CLIA data matches this NPI record on: 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 Dermatology And Plastic Surgery Of Arizona LLC's NPI number?

The NPI number for Dermatology And Plastic Surgery Of Arizona LLC is 1649611476. It was assigned to this organization in the NPPES registry on July 9, 2013.

Where is Dermatology And Plastic Surgery Of Arizona LLC located?

Dermatology And Plastic Surgery Of Arizona LLC is located at 150 S Coronado Dr Ste 110, Sierra Vista, AZ 85635. The listed phone number is (520) 458-1787.

What is Dermatology And Plastic Surgery Of Arizona LLC's specialty?

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

Is Dermatology And Plastic Surgery Of Arizona LLC enrolled in Medicare?

Yes. Dermatology And Plastic Surgery Of Arizona LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology And Plastic Surgery Of Arizona LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Dermatology And Plastic Surgery Of Arizona 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. The largest specialties are Nurse Practitioner (3), Plastic and Reconstructive Surgery (2) and Dermatology (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology And Plastic Surgery Of Arizona LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Dermatology And Plastic Surgery Of Arizona LLC was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.