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LAKE ST LOUIS DERMATOLOGY PC
NPI 1255583746
Dermatology in Lake St Louis, MO

Active since October 16, 2008CLIA 26D1093589 · Microscopy
300 MEDICAL PLZ, MOB 2, SUITE 210, LAKE ST LOUIS, MO 63367(636) 561-0026 Get Directions Write a Review

NPPES record last updated: February 11, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake St Louis Dermatology Pc NPPES

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

LAKE ST LOUIS DERMATOLOGY PC (NPI 1255583746) is a healthcare organization registered as a dermatology in Lake St Louis, Missouri and active in the NPI registry since October 2008. The organization holds a CLIA Microscopy certificate valid through December 22, 2026 and lists Maria J Canizares-heyde, Dermatologist, as its authorized official.

NPPES Registry Identity

NPI1255583746
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLAKE ST LOUIS DERMATOLOGY PC
Location Address300 MEDICAL PLZ, MOB 2, SUITE 210Lake St Louis, MO 63367-1481
Mailing Address300 Medical Plz, Mob 2, Suite 210Lake St Louis, MO 63367-1481 · (636) 561-0026
Phone(636) 561-0026
Organization SubpartNo
Authorized OfficialMaria J Canizares-heydeDermatologist · (636) 561-0026
Enumeration DateOctober 16, 2008
Last NPPES UpdateFebruary 11, 2009
✔ NPI 1255583746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in MO · MO2002031471
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.
300 MEDICAL PLZ, Lake St Louis, MO 63367
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Group Practice 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 26D1093589

Lake St Louis Dermatology · Lake Saint Louis, MO
Active · expires Dec 22, 2026
CLIA Number26D1093589
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2024
Certificate Expiration DateDecember 22, 2026
Laboratory DirectorMaria J. Canizares, MD
Laboratory Phone(636) 561-0026
Laboratory LocationLake St Louis Dermatology300 Medical Plaza Bldg #2, Ste 210, Lake Saint Louis, MO 63367
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 17

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

JAMES H HINRICHS MD LLC
Internal Medicine (Infectious Disease)
300 MEDICAL PLZ, SUITE 140
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5309
BRIAN ALLEN ANDREWS MD
Obstetrics & Gynecology
300 MEDICAL PLZ, STE 221
LAKE ST LOUIS, MO 63367
St. Charles County (636) 561-2229
DR. DOUGLAS A BARTON M.D.
Pediatrics
300 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
DR. SHAYLA S ROSE M.D.
Obstetrics & Gynecology
300 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
PHYSICIANS OF SSM ST LOUIS
Specialist
300 MEDICAL PLZ, SUITE 230
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-1111
FARHAT SHEREEN MD
Internal Medicine (Rheumatology)
300 MEDICAL PLZ, STE. 100
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 625-8300
BRIAN A. ANDREWS, MD, LLC
Clinic/Center (Medical Specialty)
300 MEDICAL PLZ, SUITE 221
LAKE ST LOUIS, MO 63367
St. Charles County (636) 561-2229
WESTPLEX HOMECARE INC.
In Home Supportive Care
300 MEDICAL PLZ, BUILDING 2 SUITE 110
LAKE ST LOUIS, MO 63367
St. Charles County (636) 695-4422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake St Louis Dermatology PC's NPI number?

The NPI number for Lake St Louis Dermatology PC is 1255583746. It was assigned to this organization in the NPPES registry on October 16, 2008.

Where is Lake St Louis Dermatology PC located?

Lake St Louis Dermatology PC is located at 300 Medical Plz Mob 2, Suite 210, Lake St Louis, MO 63367. The listed phone number is (636) 561-0026.

What is Lake St Louis Dermatology PC's specialty?

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

Does Lake St Louis Dermatology PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 26D1093589) is associated with this NPI, valid through December 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake St Louis Dermatology PC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 2 other insurers list Lake St Louis Dermatology PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake St Louis Dermatology PC was last updated on February 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.