Individual provider Active NPI

Edward Lane

  • Family Medicine Physician
  • Prosser, WA
National Provider Identifier
1013023738
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00029197 Issued in WA
Practice address
820 Memorial St Ste 1
Prosser, WA 99350-2504
Phone
(509) 786-2010
Fax
(509) 788-1794
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00029197 WA Primary

Addresses

Primary practice location

820 Memorial St Ste 1
Prosser, WA 99350-2504

Mailing address

820 Memorial St Ste 1
Prosser, WA 99350-2504
Phone (509) 786-2010

Other identifiers 6

IdentifierTypeStateIssuer
911019392OtherCOMMERCIAL
9392LAOtherWAREGENCE
8142218OtherWACHPW
1306897681OtherNPI PROSSER MEMORIAL
8142218MedicaidWA
0200684OtherWAL & I

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elane4857@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628000906 WA Practitioner - Family Practice 4587600788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers Clinic 274 clinicians

Practice addresses (Care Compare)

820 Memorial St
Suite 1
Prosser, WA 99350-2504
Phone (509) 786-2010

Hospital & facility affiliations

  • Tri-Cities Home Health Home health agency, Kennewick, WA, CCN 507010
  • Columbia River Home Health Home health agency, Kennewick, WA, CCN 507061
  • Prosser Memorial Hospital Hospital, Prosser, WA, CCN 501312
  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Astria Sunnyside Hospital Hospital, Sunnyside, WA, CCN 501330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00029197WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Aug 1, 2005 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Aug 1, 2005 Accepting new patients
Prosser Public Hospital District of Benton County Past Accepting new patients

Locations

1000 Wallace Way
Grandview, WA 98930
Phone (509) 788-1702

820 Memorial St
Ste 1
Prosser, WA 99350
Phone (509) 504-5300

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: elane4857@yvfwc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1013023738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST STE 1",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-2010",
            "fax_number": "509-788-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST STE 1",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-2010",
            "fax_number": "509-788-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00029197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "9392LA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHPW",
            "identifier": "8142218",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PROSSER MEMORIAL",
            "identifier": "1306897681",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8142218",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0200684",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elane4857@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "820 Memorial St Ste 1",
            "city": "Prosser",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993502504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosser, WA

Sources for this page

Verify at the official NPI Registry.