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YOON DERMATOLOGY LLC
NPI 1811510886
Dermatology in Wentzville, MO

Active since May 25, 2020CLIA Certified · 3 labs
1060 MEYER RD, WENTZVILLE, MO 63385(636) 466-1636(314) 645-0446 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 6, 2026, May 14, 2024, May 25, 2020 (3 updates tracked since 2020).

About Yoon Dermatology Llc NPPES

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

YOON DERMATOLOGY LLC (NPI 1811510886) is a healthcare organization registered as a dermatology in Wentzville, Missouri and active in the NPI registry since May 2020. The organization holds 3 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Jaeyoung Yoon, Owner, as its authorized official.

NPPES Registry Identity

NPI1811510886
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameYOON DERMATOLOGY LLC
Location Address1060 MEYER RDWentzville, MO 63385-3800
Mailing Address1060 Meyer RdWentzville, MO 63385-3800 · (314) 230-1500 · Fax (314) 230-1122
Phone(636) 466-1636
Fax(314) 645-0446
Organization SubpartNo
Authorized OfficialJaeyoung YoonOwner · (314) 230-1500
Enumeration DateMay 25, 2020
Last NPPES UpdateAugust 6, 20263 updates tracked since enumeration
NPPES CertifiedAugust 6, 2026
✔ NPI 1811510886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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 ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedOtolaryngology · Facial Plastic SurgeryTaxonomy 207YS0123X
1060 MEYER RD, Wentzville, MO 63385
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Secondary Practice Locations 3

Location 12105 W Pearce BlvdWentzville, MO 63385-3330 · Phone (314) 230-1500 · Fax (314) 230-1122
Location 21015 Washington Sq Ste EWashington, MO 63090-5307 · Phone (314) 230-1500 · Fax (314) 230-1122
Location 32325 Dougherty Ferry Rd Ste 207Saint Louis, MO 63122-3356 · Phone (314) 230-1500 · Fax (314) 230-1122

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yoon Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Yoon Dermatology LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Lindsey Graviett, M.D.
Dermatology
NPI 1235584822
1060 MEYER RD
Wentzville, MO 63385
(314) 230-1500
✔ PECOS✔ Accepts MedicareSame address
Omar Jassim, MD, PHD
Dermatology
NPI 1649397415
1060 MEYER RD
Wentzville, MO 63385
(314) 230-1500
✔ PECOS✔ Accepts MedicareSame address
Laura Sills, RN, MSN, ANP-BC
Nurse Practitioner
NPI 1699804104
1060 MEYER RD
Wentzville, MO 63385
(314) 230-1500
✔ PECOS✔ Accepts MedicareSame address
Jaeyoung Yoon, MD
Dermatology
NPI 1205885563
1060 MEYER RD
Wentzville, MO 63385
(314) 230-1500
✔ PECOS✔ Accepts MedicareSame address
Stacy Blum, D.O.
Dermatology
NPI 1952757007
10930 N TATUM BLVD STE C101
Phoenix, AZ 85028
(480) 500-8476
✔ PECOS✔ Accepts Medicare1,231 mi

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

CLIA Laboratory Certificates CMS CLIA 3

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 of Compliance 26D2336550

Yoon Dermatology · Washington, MO
Active · expires Jun 29, 2028
CLIA Number26D2336550
Laboratory TypePhysician Office
Certificate Effective DateJune 30, 2026
Certificate Expiration DateJune 29, 2028
Laboratory DirectorJaeyoung Yoon
Laboratory Phone(314) 230-1500
Laboratory LocationYoon Dermatology1015 Washington Square, Suite E, Washington, MO 63090
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 26D2198102

Yoon Dermatology · Wentzville, MO
Active · expires Sep 28, 2027
CLIA Number26D2198102
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 29, 2025
Certificate Expiration DateSeptember 28, 2027
Laboratory DirectorJaeyoung Yoon
Laboratory Phone(314) 230-1500
Laboratory LocationYoon Dermatology2105 West Pearce, Suite 1, Wentzville, MO 63385
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 26D2194017

Yoon Dermatology · Saint Louis, MO
Active · expires Sep 27, 2027
CLIA Number26D2194017
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorJaeyoung Yoon
Laboratory Phone(314) 230-1500
Laboratory LocationYoon Dermatology2325 Dougherty Ferry Rd, 207, Saint Louis, MO 63122
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Yoon Dermatology LLC's NPI number?

The NPI number for Yoon Dermatology LLC is 1811510886. It was assigned to this organization in the NPPES registry on May 25, 2020.

Where is Yoon Dermatology LLC located?

Yoon Dermatology LLC is located at 1060 Meyer Rd, Wentzville, MO 63385. The listed phone number is (636) 466-1636.

What is Yoon Dermatology LLC's specialty?

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

Is Yoon Dermatology LLC enrolled in Medicare?

Yes. Yoon Dermatology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Yoon Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Yoon Dermatology LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (4) and Nurse Practitioner (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Yoon Dermatology LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Yoon Dermatology LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and Medica list Yoon Dermatology LLC 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 Yoon Dermatology LLC was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.