Individual provider Active NPI

Lindall A Perry, M.D.

  • MOHS-Micrographic Surgery Physician
  • Columbia, MO
National Provider Identifier
1720036072
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
107883 Issued in MO
Practice address
401 Keene St
Columbia, MO 65201-6625
Phone
(573) 876-1616
Fax
(573) 876-1678
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 107883 MO
MOHS-Micrographic Surgery Physician 207ND0101X 107883 MO Primary

Addresses

Primary practice location

401 Keene St
Columbia, MO 65201-6625

Mailing address

401 Keene St
Columbia, MO 65201-6625
Phone (573) 876-1616

Other identifiers 1

IdentifierTypeStateIssuer
208550749MedicaidMO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070228000446 MO Practitioner - Dermatology 2365544509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Columbia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Dermatology Associates, LLPGroup PAC ID 4789803065, 15 clinicians

Practice addresses (Care Compare)

401 N Keene St
Columbia, MO 65201-6625
Phone (573) 876-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision241
Removal of tissue1-10
Removal of skin lesions1744
Removal of skin cancer998
Removal or shaving of skin growth1-10
Skin biopsy586

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107883MOMDMOHS-Micrographic Surgery Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1720036072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1616",
            "fax_number": "573-876-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1616",
            "fax_number": "573-876-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LINDALL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "107883",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "107883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208550749",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.