OMNI DERMATOLOGY OLIVE LLC
NPI 1669914172
Specialist in Glendale, AZ

NPI Status: Active since November 15, 2016

Contact Information

5700 W OLIVE AVE
STE 101
GLENDALE, AZ
ZIP 85302
Phone: (602) 559-5470
Fax: (602) 559-5471

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  • Organization
  • Specialist
  • CLIA Number: 03D1083664
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-15-2026

About OMNI DERMATOLOGY OLIVE LLC

This page provides the complete NPI Profile along with additional information for Omni Dermatology Olive Llc, a provider established in Glendale, Arizona operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1669914172 assigned on November 2016. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Andrew Joseph Racette D.o. (President)

NPI
1669914172
Provider Name
OMNI DERMATOLOGY OLIVE LLC
Entity Type
Organization
Location Address
5700 W OLIVE AVE STE 101 GLENDALE, AZ 85302
Location Phone
(602) 559-5470
Location Fax
(602) 559-5471
Mailing Address
4840 E INDIAN SCHOOL RD STE 102 PHOENIX, AZ 85018
Mailing Phone
(602) 954-3919
Mailing Fax
(602) 559-5471
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-15-2016
Last Update Date
11-15-2016
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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.

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. ANDREW JOSEPH RACETTE D.O.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(602) 954-3919

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
03D1083664
Facility Type
Physician Office
Certificate Effective Date
June 16, 2024
Certificate Expiration Date
June 15, 2026
Laboratory Director
ANDREW RACETTE
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Omni Dermatology Olive Llc 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669914172, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
1
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 4 → 8 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 8 + 1 + 8 + 1 + 1 + 4 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1669914172.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Dentist (General Practice)
5700 W OLIVE AVE, SUITE 102
GLENDALE, AZ 85302
Preferred Provider Organization
5700 W OLIVE AVE, SUITE #104
GLENDALE, AZ 85302
Clinic/Center (Dental)
5700 W OLIVE AVE
GLENDALE, AZ 85302
Dentist
5700 W OLIVE AVE, SUITE #105
GLENDALE, AZ 85302
Internal Medicine
5700 W OLIVE AVE, 108
GLENDALE, AZ 85302
Dentist
5700 W OLIVE AVE, SUITE 104
GLENDALE, AZ 85302
Internal Medicine
5700 W OLIVE AVE, STE 108
GLENDALE, AZ 85302
Music Therapist
5700 W OLIVE AVE
GLENDALE, AZ 85302

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669914172, enumerated as an "organization" on November 15, 2016.

The provider is located at 5700 W OLIVE AVE STE 101 GLENDALE, AZ 85302 and the phone number is (602) 559-5470.

Specialist with taxonomy code 174400000X.