Michelle Sue Legacy, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MI5101017676 Issued in MI

Practice address

1392 S Cass Lake Rd
Waterford, MI 48328-4741

Phone

(248) 338-6400

NPI assigned

Oct 7, 2008

Last updated

Aug 21, 2025By the provider in NPPES

Sex

Female

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 MI

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

Specialty

Dermatology

Education

Michigan State University College of Osteopathic Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Dermatology Group PCGroup PAC ID 8325338148, 5 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 Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Dermatology Group PC

  dba Legacy Dermatology Group

  • Dermatology Physician
  • Waterford, MI
  • NPI 1588019053
  Medicare reassignment Care Compare group NPD Authorized official
• Dr. Annette C. Lacasse, D.O., P.C.

  • Dermatology Physician
  • Commerce TWP, MI
  • NPI 1255405296
  NPD

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1982855110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 S CASS LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284741",
            "telephone_number": "248-338-6400",
            "fax_number": "248-338-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 S CASS LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284741",
            "telephone_number": "248-338-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 S Milford Rd",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "MI",
            "postal_code": "483574900",
            "country_code": "US",
            "telephone_number": "248-338-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGACY",
        "first_name": "MICHELLE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101017676",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "MI5101017676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Lazarus, D.D.S.
• Susan B Leclair, RDH, BS
• Adrianna Denae Lee
• Esther Lenora Lee, LLC
• Legacy Dermatology Group PC (Legacy Dermatology Group)
• Sanjot Lehal, DDS MD
• Joel K Leib, DO
• Rosalind Leiser, M.A. CCC-A
• Dolores Elaine Lemkau I, LMSW CAC-1
• Charlene Yvonne Leonardi, M.P.T.

• Dermatology Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.
• 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.