Active NPI 1356364624 Individual Practitioner Male Practitioner

Dr. Benjamin Wallace Lesueur , MD

Dermatology • Phoenix, AZ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Lesueur, MD is a certified Dermatology practicing in Phoenix, AZ. With approximately 26 years of clinical experience since graduating from University Of Arizona College Of Medicine in 2000, Dr. Lesueur delivers high-quality medical care to the local community at 11130 N TATUM BLVD.

Dr. Lesueur is affiliated with Southwest Skin Specialists Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

11130 N Tatum Blvd
#100

Phoenix, AZ 85028

Telephone 6024941817

Fax 6024947103

Associated Practice Facility / Clinic

🏢 Southwest Skin Specialists Llc Facility NPI 1174521926

Medicare Profile & Education

Medical School

University Of Arizona College Of Medicine

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Phoenix, AZ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs +5.2 yrs vs City Avg

City Avg: 20.8 Yrs

State Avg: 18.6 Yrs

Regional Practice Density

75 Specialists

Practicing in Phoenix, AZ (369 Statewide)

Telehealth Adoption Rate

4.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

73.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lesueur (26 Years) 26 Yrs

Phoenix Specialty Average (20.8 Years) 20.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,282	944	$23.00	$6.78
99213 Established patient office or other outpatient visit, typically 15 minutes	2,624	1,731	$309.00	$92.41
17000 Destruction of skin growth	1,691	1,185	$231.00	$56.03
17110 Destruction of up to 14 skin growths	610	527	$388.00	$111.08
11102 Tangential biopsy of single skin lesion	354	336	$341.00	$88.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	256	238	$435.00	$130.83
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	226	174	$608.00	$162.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	225	218	$193.04	$57.51
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	116	102	$506.00	$126.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$379.00	$112.31
17004 Destruction of precancer skin growth, 15 or more growths	93	75	$570.00	$170.54
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	61	56	$614.00	$172.48
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	57	53	$643.00	$181.57
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	56	56	$1032.00	$304.83
11103 Biopsy of related skin growth, each additional growth	40	31	$171.00	$51.46
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	26	24	$567.00	$157.31
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	25	25	$701.00	$200.34
69100 Biopsy of ear	23	23	$325.00	$77.94
10060 Simple or single drainage of skin abscess	21	21	$433.00	$129.67
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	19	$586.00	$88.18
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	19	19	$948.00	$141.87
17111 Destruction of skin growth, 15 or more growths	18	17	$453.00	$135.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$567.00	$162.36
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$246.00	$73.50
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	11	11	$658.00	$188.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,171	933	$23.00	$6.48
99213 Established patient office or other outpatient visit, typically 15 minutes	2,648	1,756	$297.00	$87.55
17000 Destruction of skin growth	1,672	1,193	$223.00	$53.20
17110 Destruction of up to 14 skin growths	530	467	$378.00	$105.42
11102 Tangential biopsy of single skin lesion	342	315	$338.00	$86.41
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	240	167	$594.00	$150.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	207	197	$186.00	$54.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	145	145	$369.00	$108.75
17004 Destruction of precancer skin growth, 15 or more growths	106	93	$562.00	$164.12
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	101	91	$492.00	$120.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	88	87	$420.00	$123.64
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	66	64	$1011.00	$295.30
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	55	51	$598.00	$163.88
11103 Biopsy of related skin growth, each additional growth	50	38	$168.00	$48.82
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	45	43	$627.00	$177.30
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	43	40	$554.00	$146.96
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	38	35	$683.00	$188.07
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	32	31	$927.00	$139.74
69100 Biopsy of ear	25	25	$321.00	$79.98
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	20	$572.00	$83.40
17111 Destruction of skin growth, 15 or more growths	17	15	$441.00	$121.34
10060 Simple or single drainage of skin abscess	17	17	$417.00	$122.10
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$238.00	$70.14
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	13	13	$1113.00	$324.95
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$813.00	$118.80
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	11	11	$658.00	$96.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,874	972	$23.00	$6.57
99213 Established patient office or other outpatient visit, typically 15 minutes	2,745	1,778	$295.00	$88.46
17000 Destruction of skin growth	1,700	1,173	$221.00	$52.37
17110 Destruction of up to 14 skin growths	571	498	$374.00	$104.51
11102 Tangential biopsy of single skin lesion	394	357	$338.00	$86.17
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	234	166	$587.00	$151.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	203	187	$184.00	$54.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	179	179	$365.00	$109.23
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	130	113	$485.00	$123.36
17004 Destruction of precancer skin growth, 15 or more growths	128	102	$554.00	$164.91
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	72	71	$591.00	$168.05
11103 Biopsy of related skin growth, each additional growth	68	59	$169.00	$49.48
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	52	48	$620.00	$175.92
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	44	40	$544.00	$143.46
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	42	42	$1000.00	$287.33
10060 Simple or single drainage of skin abscess	26	25	$409.00	$117.21
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$237.00	$71.22
69100 Biopsy of ear	24	22	$319.00	$85.20
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	23	$675.00	$201.82
17111 Destruction of skin growth, 15 or more growths	22	19	$437.00	$120.96
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	17	17	$915.00	$136.68
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	16	14	$635.00	$178.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,093	899	$21.13	$6.37
99213 Established patient office or other outpatient visit, typically 15 minutes	2,457	1,669	$289.84	$89.69
17000 Destruction of skin growth	1,525	1,107	$212.86	$51.94
17110 Destruction of up to 14 skin growths	496	426	$365.64	$105.12
11102 Tangential biopsy of single skin lesion	417	378	$335.02	$85.82
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	250	189	$574.85	$152.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	217	196	$178.71	$54.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	184	184	$358.66	$110.42
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	149	116	$478.40	$117.10
17004 Destruction of precancer skin growth, 15 or more growths	121	98	$531.81	$162.86
11103 Biopsy of related skin growth, each additional growth	89	71	$171.03	$51.48
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	63	57	$607.64	$173.36
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	61	57	$579.00	$162.54
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	48	46	$535.78	$139.86
69100 Biopsy of ear	32	30	$319.89	$68.84
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	29	29	$663.94	$203.31
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	26	26	$995.43	$298.25
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$235.27	$71.64
17111 Destruction of skin growth, 15 or more growths	20	19	$429.00	$124.24
10060 Simple or single drainage of skin abscess	15	15	$398.00	$101.48
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	11	11	$623.00	$181.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	5,811	842	$17.65	$5.91
99213 Established patient office or other outpatient visit, typically 15 minutes	1,741	1,268	$178.45	$73.96
17000 Destruction of skin growth	1,441	1,039	$156.58	$50.03
11102 Tangential biopsy of single skin lesion	489	441	$242.24	$84.83
17110 Destruction of up to 14 skin growths	404	363	$271.87	$104.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	371	296	$108.74	$44.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	322	262	$263.90	$107.02
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	271	209	$427.61	$154.51
17004 Destruction of precancer skin growth, 15 or more growths	133	111	$362.44	$156.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	103	103	$264.85	$105.54
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	97	86	$357.03	$118.81
11103 Biopsy of related skin growth, each additional growth	91	81	$128.16	$52.45
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	86	76	$450.98	$173.78
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	47	43	$452.89	$154.16
99201 New patient office or other outpatient visit, typically 10 minutes	37	37	$118.14	$45.07
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	36	30	$508.71	$188.64
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	36	33	$752.79	$294.66
69100 Biopsy of ear	31	30	$233.42	$72.11
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	28	28	$391.16	$127.72
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$191.90	$74.91
17111 Destruction of skin growth, 15 or more growths	18	16	$311.50	$118.72
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	16	16	$443.25	$189.52
10060 Simple or single drainage of skin abscess	15	14	$299.70	$116.21
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$716.31	$139.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,938	949	$13.62	$5.54
99213 Established patient office or other outpatient visit, typically 15 minutes	2,219	1,483	$151.00	$73.17
17000 Destruction of skin growth	1,769	1,189	$133.00	$50.89
11102 Tangential biopsy of single skin lesion	935	744	$202.00	$90.30
17110 Destruction of up to 14 skin growths	444	382	$226.00	$107.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	444	359	$92.00	$44.25
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	351	279	$221.00	$107.42
11103 Biopsy of related skin growth, each additional growth	316	223	$109.00	$52.56
17004 Destruction of precancer skin growth, 15 or more growths	193	152	$311.00	$150.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	164	164	$220.00	$106.88
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	66	58	$361.00	$152.24
99201 New patient office or other outpatient visit, typically 10 minutes	49	49	$93.00	$45.13
69100 Biopsy of ear	47	42	$201.00	$78.55
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	27	27	$623.00	$301.01
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	23	22	$384.00	$173.49
17111 Destruction of skin growth, 15 or more growths	22	19	$267.00	$129.23
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	20	$421.00	$193.69
10060 Simple or single drainage of skin abscess	17	16	$243.00	$114.32
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$155.00	$73.16
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	11	11	$654.00	$315.72
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	11	11	$367.00	$155.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	6,918	992	$10.00	$5.14
99213 Established patient office or other outpatient visit, typically 15 minutes	2,261	1,571	$125.00	$71.54
17000 Destruction of skin growth	1,824	1,253	$100.00	$52.49
11100 Biopsy of single growth of skin and/or tissue	915	748	$150.00	$98.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	473	378	$90.00	$43.04
17110 Destruction of up to 14 skin growths	413	357	$165.00	$108.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	380	280	$160.00	$105.89
11101 Biopsy of each additional growth of skin and/or tissue	344	222	$50.00	$32.12
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	174	174	$160.00	$106.04
17004 Destruction of precancer skin growth, 15 or more growths	151	124	$230.00	$142.04
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	58	55	$450.00	$289.49
69100 Biopsy of ear	53	51	$150.00	$78.58
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	47	39	$260.00	$150.43
99201 New patient office or other outpatient visit, typically 10 minutes	36	36	$90.00	$43.85
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	23	$250.00	$82.07
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$125.00	$72.36
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	22	20	$425.00	$139.86
10060 Simple or single drainage of skin abscess	18	15	$175.00	$117.45
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$280.00	$178.14
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	13	$300.00	$180.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	7,266	1,074	$10.00	$5.54
17000 Destruction of skin growth	1,904	1,339	$100.00	$52.85
99213 Established patient office or other outpatient visit, typically 15 minutes	1,739	1,322	$125.00	$72.00
11100 Biopsy of single growth of skin and/or tissue	1,016	807	$150.00	$97.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	856	678	$160.00	$105.93
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	534	419	$90.00	$42.95
11101 Biopsy of each additional growth of skin and/or tissue	393	240	$50.00	$32.16
17110 Destruction of up to 14 skin growths	329	290	$165.00	$108.70
17004 Destruction of precancer skin growth, 15 or more growths	255	199	$230.00	$147.81
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	188	150	$260.00	$152.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	165	165	$160.00	$105.83
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	73	65	$280.00	$171.67
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	55	53	$450.00	$299.69
99201 New patient office or other outpatient visit, typically 10 minutes	45	45	$90.00	$43.11
69100 Biopsy of ear	42	40	$150.00	$83.00
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	36	30	$300.00	$182.09
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	22	12	$10.00	$1.78
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	20	$250.00	$81.83
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	18	$425.00	$140.01
87220 Tissue fungi or parasites	17	17	$25.00	$5.74
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$125.00	$73.88
11900 Injection into skin growth, 1-7 growths	16	12	$80.00	$44.81
10140 Drainage of blood or fluid accumulation	14	14	$240.00	$161.29
10060 Simple or single drainage of skin abscess	14	13	$175.00	$116.24
17111 Destruction of skin growth, 15 or more growths	13	12	$200.00	$125.13
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	13	13	$265.00	$162.47
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$375.00	$122.53

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License AZ 29865

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.

Hospital & Practice Group Affiliations

Southwest Skin Specialists Llc

10200 N 92nd St, Scottsdale, AZ 852584536

Phone: 6024941817

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

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Dermatology

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Dr. Miriam Cummings , MD

Dermatology

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Dr. Jennifer Sawaya , MD

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NPI 1235544479

Doctor of Medicine (M.D.)

Dr. Joseph Giancola , MD

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NPI 1265455539

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active April 05, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location April 05, 2016

Registered at 11130 N TATUM BLVD, #100, PHOENIX, AZ 85028 (Tel: 6024941817)

📍

Updated Business Mailing Address April 05, 2016

Registered at 11130 N TATUM BLVD, #100, PHOENIX, AZ 85028 (Tel: 6024941817)

👤

Provider Name / Credentials Updated April 05, 2016

Recorded as BENJAMIN LESUEUR, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 05, 2016

Dermatology (License #29865 in AZ)

🟢

Initial NPI Registration & Enumeration July 26, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1356364624

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 26, 2006

Last Update: April 05, 2016

Sole Proprietor: No

Update or Correct Profile

Mailing Address

11130 N Tatum Blvd, #100

Phoenix, AZ 85028

Phone: 6024941817

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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