Individual provider Active NPI

Lawrence E Samuels, M.D.

  • Dermatology Physician
  • Chesterfield, MO
National Provider Identifier
1811983869
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R7821 Issued in MO
Practice address
222 S Woods Mill Rd
480 North
Chesterfield, MO 63017-3625
Phone
(314) 576-7343
Fax
(314) 576-7929
NPI assigned
Sep 26, 2005
Last updated
Jan 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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 R7821 MO Primary

Addresses

Primary practice location

222 S Woods Mill Rd
480 North
Chesterfield, MO 63017-3625

Mailing address

222 S Woods Mill Rd
480 North
Chesterfield, MO 63017-3625
Phone (314) 576-7343

Other identifiers 9

IdentifierTypeStateIssuer
FIRST HEALTHOtherMO5226978
CN5366OtherMORR MEDICARE
2681938001OtherMOCIGNA
125936OtherMOHEALTHLINK
STL0300034OtherMOUNITED HEALTHCARE
22849OtherMOBLUE SHIELD
32276OtherMOGROUP HEALTH PLAN
4228309OtherMOAETNA
828013496OtherMORAILROAD MEDICARE

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
I20100831000665 MO Practitioner - Dermatology 5991829780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Washington University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence E. Samuels M.D., Inc.Group PAC ID 0749221836, 3 clinicians

Practice addresses (Care Compare)

222 S Woods Mill Rd
Suite 480N
Chesterfield, MO 63017-3637
Phone (314) 576-7343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.46 of 100Reported as individual
Quality
82.91
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Melanoma (skin cancer) excision15
Removal of skin lesions2362
Removal of skin cancer130
Removal of nail tissue1-10
Skin biopsy58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7821MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence E. Samuels M.D., Inc. Dermatology CurrentSince Nov 7, 1980 Accepting new patients
Dermatology and Skin Cancer Specialists, LLC. Dermatology Past Accepting new patients

Locations

222 S Woods Mill Rd
Ste 480N
Chesterfield, MO 63017
Phone (314) 576-7336

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1811983869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "address_2": "480 NORTH",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-576-7343",
            "fax_number": "314-576-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "address_2": "480 NORTH",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-576-7343",
            "fax_number": "314-576-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "LAWRENCE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "R7821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "5226978",
            "identifier": "FIRST HEALTH",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN5366",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2681938001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "125936",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "STL0300034",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "22849",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "32276",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4228309",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "828013496",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.