Shane A Grace, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2020038382 Issued in MO

Practice address

12855 N 40 Dr Ste 180
Saint Louis, MO 63141-8657

Phone

(314) 878-5599

Fax

(314) 392-4290

NPI assigned

Jul 28, 2014

Last updated

May 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Saint Louis University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• IA HMO C-SNP
• IA HMO

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1891179040
  Medicare reassignment Care Compare group NPD
• St. Louis Dermatology and Surgery Center, PC

  • MOHS-Micrographic Surgery Physician
  • Saint Louis, MO
  • NPI 1659304061
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1033527684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 180",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-878-5599",
            "fax_number": "314-392-4290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636407616",
            "country_code": "US",
            "telephone_number": "573-760-0091",
            "fax_number": "573-760-8844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Richardson Xing Ste 130",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630106023",
            "country_code": "US",
            "telephone_number": "636-489-4770",
            "fax_number": "636-489-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACE",
        "first_name": "SHANE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2020038382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shane.Grace@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1223 Maple St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636407616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shane.Grace@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "12855 N 40 Dr Ste 180",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shane.Grace@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "130 Richardson Xing Ste 130",
            "city": "Arnold",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630106023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace Hill Health Centers, Inc.
• Grace Hill Neighborhood Health Center Inc,
• Grace Hill Neighborhood Health Ctr
• Grace Oropesa
• Emily Grace, MAT, ATC
• Graceful Gateway Transportation LLC
• Graceful Living Home Health LLC
• Gracious Adult Daycare LLC
• Gracious Growth Missouri LLC
• Gracious Loving Care LLC

• Dermatology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.