Phoenix Surgical Dermatology Group LLC
NPI 1447884929ActiveOrganization· Dermatology, MOHS-Micrographic Surgery· Phoenix, AZ
Dermatology, MOHS-Micrographic Surgery in Phoenix, Arizona, registered in NPPES in February 2020. The authorized official on file is Ramin Fathi, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1447884929 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 24, 2020 |
| Last updated in NPPES | Feb 29, 2020 |
| Certified by provider | Feb 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology, MOHS-Micrographic Surgery Primary | 207ND0101X | — | — |
| Dermatology | 207N00000X | — | — |
| Dermatology, Dermatopathology | 207ND0900X | — | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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