Prasanthi Kandula

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

274491 Issued in MA

Practice address

10287 Clayton Rd Ste 360
Saint Louis, MO 63124-1181

Phone

(314) 350-8207

NPI assigned

Apr 18, 2014

Last updated

Jan 29, 2025By 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

University of Missouri, Kansas City, School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precision Skin Care Dermatology LLCGroup PAC ID 3072043561, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkandula@pscderm.emadirect.md

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.

• Precision Skin Care Dermatology, LLC

  dba PSC Dermatology

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1306662200
  Medicare reassignment Care Compare group NPD
• Skincare Physicians Inc

  • Dermatology Physician
  • Chestnut Hill, MA
  • NPI 1508893843
  NPD
• Skincare Physicians St Elizabeths Inc

  • Dermatology Physician
  • Chestnut Hill, MA
  • NPI 1639499676
  NPD (past)
• Skincarephysicians

  • Dermatology Physician
  • Chestnut Hill, MA
  • NPI 1699005173
  NPD (past)

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1225458185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10287 CLAYTON RD STE 360",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10287 CLAYTON RD STE 360",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241181",
            "telephone_number": "314-350-8207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1244 Boylston St",
            "address_purpose": "LOCATION",
            "city": "Chestnut Hill",
            "state": "MA",
            "postal_code": "02467",
            "country_code": "US",
            "telephone_number": "617-731-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDULA",
        "first_name": "PRASANTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MA",
            "license": "274491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suman Subbaraya Kandachar, MD
• Apoorva Kandakatla, MD
• Dani Kander, DO
• Kandkseniorservicesllc
• Madhavi Kandula, MD
• Daniel T Kane, MD
• Deborah Shipley Kane, MD
• Erin Elizabeth Kane, MD
• Jerome S Kane, R.N.
• Mary E Kane, MA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.