LAURA ALEXANDRIA UPTON
NPI 1093392847
Dermatology in Saint Louis, MO

Q: What is Laura Upton's NPI number?

The NPI number for Laura Upton is 1093392847. It was assigned to this individual provider in the NPPES registry on March 26, 2021.

Q: What is Laura Upton's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Laura Upton was last updated on March 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 26, 2021PECOS Enrolled

1225 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 977-6100 Get Directions Write a Review

NPPES record last updated: March 26, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Laura Alexandria Upton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAURA ALEXANDRIA UPTON (NPI 1093392847) is an individual dermatology provider in Saint Louis, Missouri, licensed in Missouri (TBD) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Georgetown University School Of Medicine (2021).

NPPES Registry Identity

NPI1093392847

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameLAURA ALEXANDRIA UPTON

Location Address1225 S GRAND BLVDSaint Louis, MO 63104-1016

Mailing Address2255 Wisconsin Ave Nw Apt 417Washington, DC 20007-4165 · (321) 604-0034

Phone(314) 977-6100

Sole ProprietorNo

Medical School CMSGeorgetown University School Of MedicineGraduated 2021

Enumeration DateMarch 26, 2021

NPPES CertifiedMarch 26, 2021

✔ NPI 1093392847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in MO · TBD

Definition

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License TBD (MO)

1225 S GRAND BLVD, Saint Louis, MO 63104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sendero Health Plans, Local Nonprofit, WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Laura Alexandria Upton is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1355743188

PECOS Enrollment IDI20260818002409

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Laura Upton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mountain West Derm - Blackhart PLLC

693 mi

Dermatology

4513 WILLIAMS DR
Georgetown, TX 78633

Reassigned Medicare billing, Texas enrollment
22 clinicians in this Medicare group

NPI 1366018848 (512) 930-3909

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW RUSSELL SMEDS MD

Surgery (Vascular Surgery)