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Export Provider Record NPI 1043214505
Lee S PortnoffM.D.
Active
NPI Number1043214505
NPI TypeNPI-1 Individual
SpecialtyDermatology, MOHS-Micrographic Surgery
Provider Details
NPI1043214505
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2005-06-11
Last Updated2026-03-10
Mailing Address4 Dunleith Dr
Saint Louis, MO 63124-1895
United States
Phone: (314) 705-0644
📍 View Map
Primary Practice Address4 Dunleith Dr
Saint Louis, MO 63124-1895
United States
Phone: (314) 705-0644
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207ND0101X – Dermatology, MOHS-Micrographic SurgeryMOR9730
No207NS0135X – Dermatology, Procedural DermatologyMOR9730
No207N00000X – DermatologyMOR9730
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About NPI 1043214505

Lee S Portnoff M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1043214505. The primary specialty listed is Dermatology, MOHS-Micrographic Surgery. The provider is located in Saint Louis, MO. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-06-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1043214505?

NPI 1043214505 belongs to Lee S Portnoff M.D., a Dermatology, MOHS-Micrographic Surgery in Saint Louis, MO. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1043214505 active?

The current status of NPI 1043214505 in the NPPES registry is Active. The record was last updated on 2026-03-10.

What specialty is NPI 1043214505?

NPI 1043214505 is classified under the taxonomy Dermatology, MOHS-Micrographic Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1043214505?

You can verify NPI 1043214505 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1043214505?

The primary practice address on file for NPI 1043214505 is 4 Dunleith Dr, Saint Louis, MO 63124-1895. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1043214505 issued?

NPI 1043214505 was first issued (enumerated) on 2005-06-11. The NPPES record was last updated on 2026-03-10.

Practice Location Map

Lee S Portnoff is located at 4 Dunleith Dr, Saint Louis, MO. Use the map below to find directions or verify the practice location.

📍 4 Dunleith Dr, Saint Louis, MO 63124-1895  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Lee S Portnoff. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1043214505. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dermatology, MOHS-Micrographic SurgeryR9730MO
Dermatology, Procedural DermatologyR9730MO
DermatologyR9730MO
Data Verified from CMS NPPES Last synced: 2026-06-12 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162