Jennifer M Kane, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2022012789 Issued in MO

Practice address

621 S New Ballas Rd Ste 498a
Creve Coeur, MO 63141-8259

Phone

(314) 251-3376

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, MA2 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

Specialty

Dermatology

Education

University of Massachusetts Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Skin Specialists Missouri LTD PCGroup PAC ID 8123310554, 14 clinicians

South Coast Dermatology LLCGroup PAC ID 8729025028, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• United Skin Specialists Missouri LTD, PC

  • MOHS-Micrographic Surgery Physician
  • Chesterfield, MO
  • NPI 1225482839
  Medicare reassignment Care Compare group NPD
• South Coast Dermatology LLC

  • Specialist
  • Weymouth, MA
  • NPI 1215911383
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1528598760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARLSON PKWY N STE 240",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474485",
            "telephone_number": "763-367-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 498A",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418259",
            "telephone_number": "314-251-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "T0252",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "271107",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2022012789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose J. Derdoy, MD, LLC
• Lauren Josten
• Jeffrey Juang
• Julie Lafferty MD, LLC
• Tricia Ann Kaelin, SLP
• Elizabeth Kauffman
• KDB Enterprises, Inc
• Karla Keaney, M.D.
• Abbe Michelle Keen, D.C.
• Dennis J Keithly, MD

• Dermatology Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.