OMNI DERMATOLOGY INCORPORATED (NPI# 1003082090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003082090 |
| Entity Type | Organization |
| Organization Name | OMNI DERMATOLOGY INCORPORATED |
| Practice Address |
4840 E Indian School Rd Suite 105 Phoenix AZ 85018-5500 |
| Mailing Address |
4111 N Drinkwater Blvd Apt F109 Scottsdale AZ 85251-3647 |
| Practice Telephone | 4809543919 |
| Practice Fax Number | 4809543670 |
| Mailing Telephone | 6023693634 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |
| Authorized Official Name | DR. ANDREW J RACETTE (PRESIDENT) |
| Authorized Official Telephone | 6023693634 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4311 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
4840 E INDIAN SCHOOL RD SUITE 105 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85018-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760472351 | Frank E Cibulka | Family Medicine | 4840 E Indian School Rd, Suite 100, Phoenix, AZ 85018-5500 | 2005-10-25 |
| 1275989972 | Andre Tarin | Nurse Practitioner | 4840 E Indian School Rd, Suite #102, Phoenix, AZ 85018-5500 | 2016-05-11 |
| 1023382041 | Scottsdale Healthcare Corp | Family Medicine | 4840 E Indian School Rd, Suite 101, Phoenix, AZ 85018-5500 | 2012-03-08 |
| 1841576402 | Danielle Lynn Krotin | Physical Therapist | 4840 E Indian School Rd, Phoenix, AZ 85018-5500 | 2011-10-27 |
| 1447530027 | Arizona Injury Medical Associates, P.l.l.c. | Psychiatry & Neurology | 4840 E Indian School Rd, Suite 104, Phoenix, AZ 85018-5500 | 2011-08-26 |
| 1336433242 | Cheryl B Hnatiuk | Nurse Practitioner | 4840 E Indian School Rd, Suite 101, Phoenix, AZ 85018-5500 | 2011-06-08 |
| 1083918551 | Kristen Noel Peterson | Nurse Practitioner | 4840 E Indian School Rd, #102, Phoenix, AZ 85018-5500 | 2010-12-27 |
| 1578885026 | Michael Marcelino Cruz | Specialist/Technologist | 4840 E Indian School Rd, Suite 103, Phoenix, AZ 85018-5500 | 2010-02-25 |
| 1740424647 | Kelli Anderson | Nurse Practitioner | 4840 E Indian School Rd, Phoenix, AZ 85018-5500 | 2009-04-23 |
| 1124279682 | Tina Lynn Busby | Nurse Practitioner | 4840 E Indian School Rd, Suite 101, Phoenix, AZ 85018-5500 | 2008-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467098483 | Skyfalls LLC | Plastic Surgery | 3723 E Sells Drive, Phoenix, AZ 85018 | 2019-11-25 |
| 1568944148 | Avicenna Integrative Medicine Plc | Internal Medicine | 4429 N 44th St, Phoenix, AZ 85018 | 2018-08-30 |
| 1124547682 | Consulting Options, LLC | Orthopaedic Surgery | 5110 North 44th Street, Suite L200, Phoenix, AZ 85018 | 2017-09-15 |
| 1902322472 | Saskia Soliz | Behavioral Analyst | 2940 N 40th Street, Unit 19, Phoenix, AZ 85018 | 2017-08-16 |
| 1700233418 | Harriet Frost | Marriage & Family Therapist | 4500 N. 32nd Street, Suite 100-d, Phoenix, AZ 85018 | 2016-05-23 |
| 1356733547 | Margaret Murphy Conley | Acupuncturist | 3040 N 44th St Ste 3, Phoenix, AZ 85018 | 2015-02-24 |
| 1457766792 | Anne Marie Hatch | Psychiatry & Neurology | 5090 N 40th St Ste 250a, Phoenix, AZ 85018 | 2014-06-25 |
| 1972848315 | Crystal M Ostermeyer | Physician Assistant | 4350 East Camelback Rd, Suite G-100, Phoenix, AZ 85018 | 2012-12-11 |
| 1699029652 | Monte Vista School | Local Education Agency (LEA) | 3501 E. Osborn Road, Phoenix, AZ 85018 | 2012-10-30 |
| 1962754028 | Jill R. Zweig D.o., PC | Psychiatry & Neurology | 5110 N 40th Street, Suite 104, Phoenix, AZ 85018 | 2012-10-12 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427735 | Derma Healthcare Solutions Pllc | Dermatology | 4716 E Thunderbird Rd, Phoenix, AZ 85032-5541 | 2020-05-04 |
| 1114485646 | Saguaro Dermatology Associates LLC | Dermatology | 3400 E Mcdowell Rd Fl 2, Phoenix, AZ 85008-3884 | 2019-03-04 |
| 1396122727 | Thomas Lee | Dermatology | 2525 W Carefree Hwy Ste 144, Phoenix, AZ 85085-6096 | 2015-05-06 |
| 1790174167 | Kelly Christine Collins | Dermatology | 42211 N 41st Dr. #a109, Phoenix, AZ 85086 | 2015-01-22 |
| 1215374186 | Ramin Fathi | Dermatology | 4550 E Bell Rd Bldg 5, Phoenix, AZ 85032-9390 | 2013-05-31 |
| 1699087809 | Morgan James Mackey | Dermatology | 9327 N 3rd St Ste 206, Phoenix, AZ 85020-2473 | 2010-07-06 |
| 1609900299 | Lindsay Skye Ackerman | Dermatology | 1331 N 7th St Ste 250, Phoenix, AZ 85006-2722 | 2007-03-15 |
| 1538238373 | Susan Il Iorio | Dermatology | 4400 N. 32nd Street, Ste250, Phoenix, AZ 85018 | 2006-11-07 |
| 1598869687 | Mark Richard Rosenberg | Dermatology | 20950n Tatum Blvd 350, Phoenix, AZ 85050-4256 | 2006-09-11 |
| 1538272596 | Peter J. Casper | Dermatology | 2928 N 18th Pl, Peter J. Casper, M.d., Phoenix, AZ 85016-7705 | 2006-08-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.