Legacy Dermatology Group PC
NPI 1588019053 · Dermatology Physician · Waterford, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Legacy Dermatology Group PC is a Dermatology Physician organization in Waterford, MI (NPI 1588019053).
Provider details
- NPI number
- 1588019053
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Legacy, President(248) 338-6400
- License
- 5101017676 (MI)
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
10 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
Other names (DBA / former)
- Doing business as
- Legacy Dermatology Group
- Doing business as
- Legacy Dermatology Group
Registry dates
- Enumerated
- 2016-05-03
- Last updated
- 2020-04-30
- Certified
- 2020-04-30
Frequently asked questions
- What is Legacy Dermatology Group PC's NPI number?
- Legacy Dermatology Group PC's National Provider Identifier (NPI) is 1588019053, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Legacy Dermatology Group PC?
- Legacy Dermatology Group PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Legacy Dermatology Group PC located?
- Legacy Dermatology Group PC's practice location on file with NPPES is 1392 S Cass Lake Rd, Waterford, MI 48328.
- What is Legacy Dermatology Group PC's phone number?
- The practice phone number listed in the NPPES registry for Legacy Dermatology Group PC is (248) 338-6400.
- Does Legacy Dermatology Group PC accept Medicare?
- Legacy Dermatology Group 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 Legacy Dermatology Group PC?
- The authorized official listed on Legacy Dermatology Group PC's NPPES record is Michelle Legacy, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Legacy Dermatology Group PC's NPI active?
- Yes — Legacy Dermatology Group PC's NPI (1588019053) is active in the NPPES registry as of the last update on 2020-04-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.