LEE S. PORTNOFF, M.D., P.C. NPI 1003025560

Dermatology (MOHS-Micrographic Surgery) in Saint Louis, MO

NPI 1003025560 Organization Dermatology MOHS-Micrographic Surgery CLIA Number 26D0440044 CLIA Certificate of Compliance

About LEE S. PORTNOFF, M.D., P.C.

Lee S. Portnoff, M.d., P.c. is a provider established in Saint Louis, Missouri specializing in dermatology (mohs-micrographic surgery) . The NPI number of Lee S. Portnoff, M.d., P.c. is 1003025560 and was assigned on May 2007. The practitioner's primary taxonomy code is 207ND0101X with license number R9730 (MO). The provider is registered as an organization and their NPI record was last updated 14 years ago. Lee S. Portnoff, M.d., P.c. operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Lee S Portnoff M.d. (President)

The CLIA number of Lee S. Portnoff, M.d., P.c. is 26D0440044 registered as a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Lee S. Portnoff, M.d., P.c. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

NPI

1003025560

Provider NameLEE S. PORTNOFF, M.D., P.C.
Provider Location Address3009 N BALLAS RD STE 235A SAINT LOUIS, MO 63131
Provider Mailing Address3009 N BALLAS RD STE 235A SAINT LOUIS, MO 63131
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-22-2007
Last Update Date09-20-2007


Primary Taxonomy

Taxonomy Code207ND0101X
ClassificationDermatology
TypeAllopathic & Osteopathic Physicians
SpecializationMOHS-Micrographic Surgery
License No.R9730
License StateMO
Taxonomy DescriptionThe highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Business Address

LEE S. PORTNOFF, M.D., P.C.
3009 N BALLAS RD
STE 235A
SAINT LOUIS, MO
ZIP 63131
Phone: (314) 993-2909

Get Directions


Mailing Address

LEE S. PORTNOFF, M.D., P.C.
3009 N BALLAS RD
STE 235A
SAINT LOUIS, MO
ZIP 63131
Phone: (314) 993-2909



Authorized Official

Authorized Official NameDR. LEE S PORTNOFF M.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(314) 993-2909

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003025560 is:

CLIA Number26D0440044
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Compliance

Group Taxonomy


193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207N00000XAllopathic & Osteopathic PhysiciansDermatologyR9730MONo

Taxonomy Description: a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

2207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyR9730MONo

Taxonomy Description: procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
10431MEDICARE UPIN (02)MO

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043214505DR. LEE S PORTNOFF M.D.
Individual
Dermatology (MOHS-Micrographic Surgery)3009 N BALLAS RD STE 310A
SAINT LOUIS, MO 63131
(314) 993-2909
1962400143DR. FRED ROANLD MONTERUBIO JR. M.D.
Individual
Obstetrics & Gynecology3009 N BALLAS RD STE 356C
SAINT LOUIS, MO 63131
(314) 432-2880
1669470878DR. JOHN THOMAS ANSTEY M.D.
Individual
Obstetrics & Gynecology3009 N BALLAS RD STE 356C
SAINT LOUIS, MO 63131
(314) 432-2880
1801883798NEUROLOGY ASSOCIATES, INC.
Organization
Specialist3009 N BALLAS RD SUITE 102B
SAINT LOUIS, MO 63131
(314) 725-2010
1710976394DR. DAVID B ROBSON MD
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)3009 N BALLAS RD SUITE 320 A
SAINT LOUIS, MO 63131
(314) 991-7707
1174505127ST LOUIS MEDICAL CLINIC, P.C.
Organization
Podiatrist3009 N BALLAS RD SUITE 100B
SAINT LOUIS, MO 63131
(314) 432-1111
1619957917 LISSA LOPEZ-CONCAGH MD
Individual
Internal Medicine (Nephrology)3009 N BALLAS RD SUITE 365, BLDG C
SAINT LOUIS, MO 63131
(314) 991-0137
1801876198 JUAN C GARCIA MD
Individual
Internal Medicine (Nephrology)3009 N BALLAS RD SUITE 365, BLDG C
SAINT LOUIS, MO 63131
(314) 991-0137
1952372096GATEWAY SPINE, LLC
Organization
Orthopaedic Surgery3009 N BALLAS RD SUITE 131 A
SAINT LOUIS, MO 63131
(314) 993-6170
1447221395PULMONARY & CRITICAL CARE MEDICINE, LLC
Organization
Internal Medicine (Pulmonary Disease)3009 N BALLAS RD SUITE 251C
SAINT LOUIS, MO 63131
(314) 569-2680
1417920927DR. THOMAS J GRECO M.D.
Individual
Internal Medicine3009 N BALLAS RD SUITE A226
SAINT LOUIS, MO 63131
(314) 432-5555
1780650549DR. MITCHELL DAVID BOTNEY M.D.
Individual
Internal Medicine (Pulmonary Disease)3009 N BALLAS RD 256C
SAINT LOUIS, MO 63131
(314) 692-2228
1033186663MIDWEST MEDICAL ASSOCIATES, INC
Organization
Internal Medicine3009 N BALLAS RD SUITE 300A
SAINT LOUIS, MO 63131
(314) 872-9900
1902868185DR. DANA VALENCIA M.D.
Individual
Specialist3009 N BALLAS RD SUITE 202B
SAINT LOUIS, MO 63131
(314) 995-6839
1477515047DR. JEROME VALENTINE DWYER M.D.
Individual
Specialist3009 N BALLAS RD SUITE 202B
SAINT LOUIS, MO 63131
(314) 995-6839
1780640037DR. MICHAEL B. GUTWEIN M.D.
Individual
Internal Medicine (Infectious Disease)3009 N BALLAS RD SUITE 130A
SAINT LOUIS, MO 63131
(314) 996-5540
1568403079PRUETT SURGICAL ASSOCIATES, LLC
Organization
Specialist3009 N BALLAS RD 132A
SAINT LOUIS, MO 63131
(314) 995-6999
1275579526DR. FRANK JOSEPH CATANZARO JR. M.D.
Individual
Ophthalmology3009 N BALLAS RD SUITE 205B
SAINT LOUIS, MO 63131
(314) 997-3210
1427094705DR. CHRISTOPHER S PRUETT M.D.
Individual
Surgery3009 N BALLAS RD 132A
SAINT LOUIS, MO 63131
(314) 995-6999
1750318341DR. BARRY N ROSENBLUM M.D.
Individual
Otolaryngology3009 N BALLAS RD SUITE 351C
SAINT LOUIS, MO 63131
(314) 996-4790

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.