Brooke Noelle Shadel, MD, PHD, MPH

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2007018113 Issued in MO

Practice address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Phone

(314) 251-6000

NPI assigned

Jul 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatological Care, Inc.Group PAC ID 1153303011, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dermatological Care, Inc.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1720005770
  Medicare reassignment Care Compare group NPD
• Distinctive Dermatologyltd

  • Dermatology Physician
  • Swansea, IL
  • NPI 1518028398
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134327018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 MILENTZ AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093528",
            "telephone_number": "314-435-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADEL",
        "first_name": "BROOKE",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2007018113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neema Shabazz
• Ruth Shach
• Maria Shackelford
• Bridget A Shade, PARTNER
• Isaac Shade
• Ghazal Shadmani, MD
• Michael Stuart Shadwell
• Charese Shadwick, PHARMD, BCPP
• Kristine Shady Lewis, MD
• Kevin L Shady, MD

• 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 Jul 8, 2007; 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.