REGENCY SKIN INSTITUTE PLLC (NPI# 1932630563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932630563 |
| Entity Type | Organization |
| Organization Name | REGENCY SKIN INSTITUTE PLLC |
| Practice Address |
10240 W Indian School Rd Suite 115 Phoenix AZ 85037-5904 |
| Practice Telephone | 9892554794 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | JASON LEE MUSSMAN (PLASTIC SURGEON) |
| Authorized Official Telephone | 9892554794 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
49090 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
10240 W INDIAN SCHOOL RD SUITE 115 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85037-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648145 | Niranjan R. Chandragiri | Psychiatry & Neurology | 10240 W Indian School Rd, Ste 115, Phoenix, AZ 85037-5904 | 2005-06-09 |
| 1689236135 | Vmd Primary Providers of Arizona | Internal Medicine | 10240 W Indian School Rd, Phoenix, AZ 85037-5904 | 2019-07-05 |
| 1548510365 | Healthy Life Corporation | Family Medicine | 10240 W Indian School Rd, Suite 155, Phoenix, AZ 85037-5904 | 2012-09-19 |
| 1104086032 | Sarah Elizabeth Colwell | Obstetrics & Gynecology | 10240 W Indian School Rd, Blr 2 Ste 140, Phoenix, AZ 85037-5904 | 2008-06-13 |
| 1821266271 | William B. Robey, M.d., P.C. | Family Medicine | 10240 W Indian School Rd, Ste 155, Phoenix, AZ 85037-5904 | 2008-02-19 |
| 1164618831 | Agnieszka M Chrostowski, M.d., PC | Family Medicine | 10240 W Indian School Rd, Ste155, Phoenix, AZ 85037-5904 | 2007-09-17 |
| 1801086681 | Gregory K. Chrostowski, M.d.,pc | Family Medicine | 10240 W Indian School Rd, Suite 155, Phoenix, AZ 85037-5904 | 2007-07-27 |
| 1912105420 | Bj Ho | Obstetrics & Gynecology | 10240 W Indian School Rd, Bldg 2 Suite 140, Phoenix, AZ 85037-5904 | 2007-07-05 |
| 1386865004 | Rebekah Johannah Allen | Nurse Practitioner | 10240 W Indian School Rd, Suite 155, Phoenix, AZ 85037-5904 | 2007-05-01 |
| 1235355843 | Renee Ann Ostin | Nurse Practitioner | 10240 W Indian School Rd, 155, Phoenix, AZ 85037-5904 | 2007-04-18 |
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|---|---|---|---|---|
| 1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
| 1770126260 | Medical Management Systems, Inc. | Assisted Living Facility | 2209 N. Rascon Loop, Phoenix, AZ 85037 | 2019-10-28 |
| 1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
| 1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
| 1740751320 | Mariposa Phoenix Al Partners, Lp | Assisted Living Facility | 3100 N 91st Avenue, Phoenix, AZ 85037 | 2018-12-08 |
| 1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
| 1922522242 | Tree of Life Mental Health Systems, LLC | Behavior Technician | 8400 W. Virginia, #1138, Phoenix, AZ 85037 | 2017-07-28 |
| 1720500465 | Moc Phoenix, LLC | Assisted Living Facility | 3000 N. 91st Avenue, Phoenix, AZ 85037 | 2017-07-14 |
| 1407385826 | Not Alone Home Care, LLC | In Home Supportive Care | 9422 W Palm Lane, Phoenix, AZ 85037 | 2017-06-08 |
| 1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
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| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| 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. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114567997 | J. Robert West, M.d., Inc | Dermatology | 12251 N 32nd St Ste 12, Phoenix, AZ 85032-7144 | 2020-01-09 |
| 1417906280 | Betty A Hinderks Davis | Dermatology | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2006-05-09 |
| 1609291848 | Richard Lee Averitte Jr Pllc | Dermatology | 19646 N 27th Ave, Ste 305, Phoenix, AZ 85027-4017 | 2014-02-25 |
| 1972766921 | Amena Marie Deluca | Dermatology | 4512 N 40th St, Phoenix, AZ 85018-3604 | 2008-07-09 |
| 1225175441 | Camelback Dermatology & Skin Surgery, Inc | Dermatology | 4512 N 40th St, Phoenix, AZ 85018-3600 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093228314 | Scottsdale Dermatology and Cosmetic Surgery Pllc | Dermatology | 10210 N 92nd St Ste 300, Scottsdale, AZ 85258-4525 | 2017-11-08 |
| 1548652878 | Dustin James Mullens | Dermatology | 7331 E Osborn Dr Ste 250, Scottsdale, AZ 85251-6415 | 2015-02-24 |
| 1386061257 | Lauren Marie Ogrich | Dermatology | 20201 N Scottsdale Healthcare Dr Ste 260, Scottsdale, AZ 85255 | 2014-03-27 |
| 1922360601 | Lara E. Rosenbaum | Dermatology | 6316 W Union Hills Dr Ste 200, Glendale, AZ 85308-1001 | 2012-06-08 |
| 1992061162 | Arizona Dermatology Specialists, Pllc | Dermatology | 14800 W. Mountain View Blvd., Ste. 160, Surprise, AZ 85374-2700 | 2012-04-02 |
| 1396868337 | Donald P Kadunce | Dermatology | 735 Little Dr, Lake Havasu City, AZ 86406-8308 | 2007-04-06 |
| 1821046772 | Vernon Thomas Mackey | Dermatology | 9191 W Thunderbird Rd, D-101, Peoria, AZ 85381-4270 | 2006-05-04 |
| 1629071907 | Julio Hernandez | Dermatology | 6525 W Sack Dr, Ste 307, Glendale, AZ 85308-7107 | 2005-05-31 |
| 1588297402 | Arizona Mohs Surgery, Pllc | Dermatology | 7530 N Oracle Rd Ste 102, Tucson, AZ 85704-4450 | 2020-02-19 |
| 1386091163 | Andrew Newman | Dermatology | 7331 E Osborn Dr Ste 250, Scottsdale, AZ 85251-6415 | 2016-05-20 |
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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.