Lake St Louis Dermatology PC
NPI 1255583746 · Dermatology Physician · Lake St Louis, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake St Louis Dermatology PC is a Dermatology Physician organization in Lake St Louis, MO (NPI 1255583746).
Provider details
- NPI number
- 1255583746
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Maria Canizares-Heyde, Dermatologist(636) 561-0026
- License
- MO2002031471 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-10-16
- Last updated
- 2009-02-11
Frequently asked questions
- What is Lake St Louis Dermatology PC's NPI number?
- Lake St Louis Dermatology PC's National Provider Identifier (NPI) is 1255583746, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake St Louis Dermatology PC?
- Lake St Louis Dermatology PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lake St Louis Dermatology PC located?
- Lake St Louis Dermatology PC's practice location on file with NPPES is 300 Medical Plz, Lake St Louis, MO 63367-1481.
- What is Lake St Louis Dermatology PC's phone number?
- The practice phone number listed in the NPPES registry for Lake St Louis Dermatology PC is (636) 561-0026.
- Does Lake St Louis Dermatology PC accept Medicare?
- Lake St Louis Dermatology PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake St Louis Dermatology PC?
- The authorized official listed on Lake St Louis Dermatology PC's NPPES record is Maria Canizares-Heyde, Dermatologist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake St Louis Dermatology PC's NPI active?
- Yes — Lake St Louis Dermatology PC's NPI (1255583746) is active in the NPPES registry as of the last update on 2009-02-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.