Individual provider Active NPI

Daniel G Tinker, MD

  • Dermatology Physician
  • St Louis, MO
National Provider Identifier
1417449869
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2023049006 Issued in OR
Practice address
12200 Weber Hill Rd
St Louis, MO 63127
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2023049006 OR Primary

Addresses

Primary practice location

12200 Weber Hill Rd
St Louis, MO 63127

Mailing address

12200 Weber Hill Rd Ste 200
Saint Louis, MO 63127-1569

Other practice location 1

540 E Cherry St
Troy, MO 63379-1410
Phone (314) 834-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240806002339 MO Practitioner - Dermatology 9931455698 Reassigns benefits to 2 organizations
I20260316002950 OR Practitioner - Dermatology 9931455698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Oklahoma College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatological Care, Inc.Group PAC ID 1153303011, 11 clinicians
Clear Choice DermatologyGroup PAC ID 4789005034, 47 clinicians

Practice addresses (Care Compare)

12200 Weber Hill Rd
Suite 200
Saint Louis, MO 63127-1569
Phone (314) 842-5660

123 C Ave
Lake Oswego, OR 97034-2353
Phone (541) 316-6575

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions461
Removal or shaving of skin growth1-10
Skin biopsy87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023049006ORMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Choice Dermatology Dermatology CurrentSince Apr 1, 2026 Accepting new patients
United Skin Specialists Missouri LTD, PC CurrentSince Aug 1, 2025 Accepting new patients
Dermatological Care, Inc. Dermatology CurrentSince Apr 29, 2025 Accepting new patients
United Skin Specialists Missouri LTD, PC Dermatology CurrentSince Aug 1, 2025 Accepting new patients
Troy Dermatology Surgery Center, LLC Dermatology CurrentSince Aug 11, 2024 Accepting new patients

Locations

1001 Chesterfield Pkwy E
Ste 201
Chesterfield, MO 63017
Phone (314) 434-8477

1001 Chesterfield Pkwy E
Ste 101
Chesterfield, MO 63017
Phone (314) 878-3839

12200 Weber Hill Rd
Ste 200
Saint Louis, MO 63127
Phone (314) 842-5660

520 E Cherry St
Troy, MO 63379
Phone (314) 834-1400

540 E Cherry St
Troy, MO 63379
Phone (314) 834-1400

123 C Ave
Lake Oswego, OR 97034
Phone (702) 550-9784

966 12th St SE
Ste 130
Salem, OR 97302
Phone (503) 540-7477

Interoperability endpoints

  • Direct secure messaging: dtinker923618@oc.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1417449869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 WEBER HILL RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WEBER HILL RD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 E Cherry St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633791410",
            "country_code": "US",
            "telephone_number": "314-834-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINKER",
        "first_name": "DANIEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "2023049006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.