Individual provider Active NPI

Douglas Michael Leone, M.D.

  • Dermatology Physician
  • Branson, MO
National Provider Identifier
1255523296
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2022035062 Issued in MO
Practice address
110 Business Park Dr Ste C
Branson, MO 65616-7449
Phone
(417) 336-0033
Fax
(309) 452-3376
NPI assigned
Aug 14, 2007
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 54438 WI
Dermatology Physician 207N00000X 036.129240 IL
Dermatology Physician 207N00000X 333863 LA
MOHS-Micrographic Surgery Physician 207ND0101X 036.129240 IL
Dermatology Physician 207N00000X 2022035062 MO Primary

Addresses

Primary practice location

110 Business Park Dr Ste C
Branson, MO 65616-7449

Mailing address

110 Business Park Dr Ste C
Branson, MO 65616-7449
Phone (417) 336-0033

Other practice location 1

3302 Gerig Dr Ste 100
Bloomington, IL 61704-6343
Phone (309) 533-7070

Other practice location 2

2011 Rock St Ste C
Peru, IL 61354-1392
Phone (815) 410-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, FL, LA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20130618000631 IL Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 4284821828 Reassigns benefits to 1 organization
I20220926000866 MO Practitioner - Dermatology 4284821828 Reassigns benefits to 1 organization
I20230331001495 FL Practitioner - Dermatology 4284821828 Reassigns benefits to 1 organization
I20230428002672 LA Practitioner - Dermatology 4284821828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Mohs Surgery Skin Cancer CenterGroup PAC ID 8527447945, 8 clinicians
Cenla DermatologyGroup PAC ID 0446679161, 6 clinicians
Dermatology and Skin Cancer CenterGroup PAC ID 2668821919, 6 clinicians

Practice addresses (Care Compare)

110 Business Park Dr
Suite C
Branson, MO 65616-7449
Phone (417) 336-0033

1587 N Bolton Ave
Suite 1300
Alexandria, LA 71303-4255
Phone (318) 933-3376

3302 Gerig Dr
Suite 100
Bloomington, IL 61704-6343
Phone (309) 533-7070

Merit-based Incentive Payment System (MIPS)

Final score
80.39 of 100Reported as individual
Quality
64.88
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.28 of 100Reported as individual
Quality
78.69
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as group
Quality
97.78
Promoting interoperability
100
Improvement activities
40
Cost
77.93

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as individual
Quality
80.3
Promoting interoperability
100
Improvement activities
40
Cost
59.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision409
Removal of skin lesions1460
Removal of skin cancer1238
Removal or shaving of skin growth623
Skin biopsy89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.129240ILMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Skin Cancer Center Dermatology CurrentSince Feb 1, 2024 Accepting new patients
Coastal Skin Surgery and Dermatology, PL Dermatology CurrentSince May 8, 2023 Accepting new patients
Dermatology and Mohs Surgery Skin Cancer Center Dermatology CurrentSince Sep 19, 2022 Accepting new patients
Dermatology and Mohs Surgery Center LLC Dermatology Current Accepting new patients
Cenla Dermatology Dermatology CurrentSince Apr 1, 2023 Accepting new patients
The Vein Specialists, LLC CurrentSince Feb 1, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Mike Swann, MD, LLC Past Accepting new patients

Locations

12469 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 650-7877

12469 US Highway 98 W
Ste 101
Miramar Beach, FL 32550
Phone (850) 654-3376

3302 Gerig Dr
Ste 100
Bloomington, IL 61704
Phone (309) 533-7070

2011 Rock St
Ste C
Peru, IL 61354
Phone (309) 862-4000

1508 W Reynolds St
Pontiac, IL 61764
Phone (309) 533-7070

1587 N Bolton Ave
Ste 1300
Alexandria, LA 71303
Phone 3184439773400

110 Business Park Dr
Ste C
Branson, MO 65616
Phone (417) 239-0125

914 Alexis
Lebanon, MO 65536
Phone (417) 336-0033

10101 Stoltz Dr
Rolla, MO 65401
Phone (417) 336-0033

1230 E Kingsley St
Ste A
Springfield, MO 65804
Phone (417) 720-4916

1230 E Kingsley St
Ste Ab
Springfield, MO 65804
Phone (417) 336-0033

Interoperability endpoints

  • Direct secure messaging: dleone@dermandmohs.emadirect.md

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1255523296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "309-452-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3302 Gerig Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617046343",
            "country_code": "US",
            "telephone_number": "309-533-7070",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2011 Rock St Ste C",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IL",
            "postal_code": "613541392",
            "country_code": "US",
            "telephone_number": "815-410-4555",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONE",
        "first_name": "DOUGLAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "54438",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.129240",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "333863",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036.129240",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2022035062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.