Derek Miguel Leroux Smith, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

57594 Issued in MN

Practice address

2990 Centre Pointe Dr
Roseville, MN 55113-1182

Phone

(651) 638-1560

NPI assigned

Aug 1, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD (past)
• Prairiecare LLC

  dba PrairieCare

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928
  NPD (past)
• St. Croix Psychiatric, LLC

  dba PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1316293889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18432 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449288",
            "telephone_number": "952-992-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 CENTRE POINTE DR",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131182",
            "telephone_number": "651-638-1560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6363 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352129",
            "country_code": "US",
            "telephone_number": "952-230-9100",
            "fax_number": "952-922-2525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5500 94th Ave N",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "55443",
            "country_code": "US",
            "telephone_number": "651-428-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEROUX SMITH",
        "first_name": "DEREK",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "57594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Mary Leitschuh, RN, CNP
• Dawn Mary Lems
• Rachel Elizabeth Lenz, PA-C
• Jorge A Leon, MD
• Christopher Scott Leonard, M.D.
• Benjamin Levy, DO
• Cory Lewis
• Jamaia S Lewis
• Lexington Dental
• Yajing Li, PHARMD

• Child & Adolescent Psychiatry Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Child & Adolescent Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.