Individual provider Active NPI

Sandra Evelyn Lane, MD

  • Sports Medicine (Family Medicine) Physician
  • Punta Gorda, FL
National Provider Identifier
1023087467
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME136355 Issued in FL
Practice address
315 E Olympia Ave Unit 211
Punta Gorda, FL 33950-3823
Phone
(941) 637-2663
Fax
(941) 637-6872
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 35052191 OH
Sports Medicine (Family Medicine) Physician 207QS0010X ME136355 FL Primary

Addresses

Primary practice location

315 E Olympia Ave Unit 211
Punta Gorda, FL 33950-3823

Mailing address

315 E Olympia Ave Unit 211
Punta Gorda, FL 33950-3823
Phone (941) 637-2663

Other identifiers 10

IdentifierTypeStateIssuer
0671269MedicaidOH
000000209373OtherANTHEM
311157926SALOtherSUMMIT
P00131420OtherCIGNA
310846816007OtherPRUDENTIAL
6567OtherNATIONWIDE
010064146OtherRAILROAD MEDICARE
4015568OtherAETNA
000000226360OtherANTHEM
2300473OtherUNITED HEALTHCARE

Other names 1

  • Sandra Lane Joseph Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL associatesinorthopedics@comcast.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060711000395 OH Practitioner - Sports MedicinePractitioner - Preventive Medicine 8729982145 Reassigns benefits to 1 organization
I20200110000564 FL Practitioner - Sports Medicine 8729982145 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Neurological Consultants, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Associates in Orthopedics P a CurrentSince Jan 1, 2020 Accepting new patients
Orthopedic & Neurological Consultants, Inc CurrentSince Jul 1, 2013 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Orthopedics and Sports Medicine Incorporated Past Accepting new patients

Locations

315 E Olympia Ave
Unit 211
Punta Gorda, FL 33950
Phone (941) 637-2663

L 3973
Columbus, OH 43260

1313 Olentangy River Rd
Columbus, OH 43212
Phone (614) 221-3725

70 S Cleveland Ave
Westerville, OH 43081
Phone (614) 839-2115

Interoperability endpoints

  • Direct secure messaging: slane@orthon1642.srs-direct.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1023087467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E OLYMPIA AVE UNIT 211",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503823",
            "telephone_number": "941-637-2663",
            "fax_number": "941-637-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E OLYMPIA AVE UNIT 211",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503823",
            "telephone_number": "941-637-2663",
            "fax_number": "941-637-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "SANDRA",
        "middle_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35052191",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME136355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671269",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000209373",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMIT",
            "identifier": "311157926SAL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "P00131420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUDENTIAL",
            "identifier": "310846816007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "6567",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010064146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4015568",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000226360",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2300473",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "associatesinorthopedics@comcast.net",
            "affiliation": "N",
            "address_1": "315 E Olympia Ave Unit 211",
            "city": "Punta Gorda",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339503823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "JOSEPH",
            "middle_name": "LANE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.