NPIMap

Organization Active NPI

Dermasurgery Center, LLC

  • Dermatology Physician
  • Metairie, LA
National Provider Identifier
1053579862
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD.200242 Issued in LA
Legal business name
DERMASURGERY CENTER, LLC
Practice address
111 Veterans Memorial Blvd Ste 406
Metairie, LA 70005-3061
Phone
(504) 838-8225
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Dr. Edward Lain, M.D.
Title
MD
Phone
(225) 303-9500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X MD.200242 LA Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X MD.200242 LA
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X MD.200242 LA
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X MD.200242 LA

Addresses

Primary practice location

111 Veterans Memorial Blvd Ste 406
Metairie, LA 70005-3061

Mailing address

PO Box 746767
Atlanta, GA 30374-6767
Phone (225) 303-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080811000028 LA Part B Supplier - Clinic/Group Practice 8022182922 Receives reassigned benefits from 6 practitioners
Practice locations: Baton Rouge, LA; New Orleans, LA; Metairie, LA; Lafayette, LA; Bossier City, LA

National Provider Directory

National Provider Directory

Locations

7414 Picardy Ave
Ste C
Baton Rouge, LA 70808
Phone (225) 303-9500

2910 Shed Rd
Ste C
Bossier City, LA 71111
Phone (318) 742-5124

1245 Camellia Blvd
Ste 100
Lafayette, LA 70508

1245 Camellia Blvd
Lafayette, LA 70508

1245 Camellia Blvd
Ste 300
Lafayette, LA 70508
Phone (337) 839-2773

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1053579862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746767",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746767",
            "telephone_number": "225-303-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VETERANS MEMORIAL BLVD STE 406",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700053061",
            "telephone_number": "504-838-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMASURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "LAIN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "225-303-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.200242",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "LA",
            "license": "MD.200242",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "LA",
            "license": "MD.200242",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "MD.200242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.