Active NPI
Lance L Lane, PA-C
- Physician Assistant
- Belleville, IL
National Provider Identifier
1023088655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085001883
- Practice address
- 4700 Memorial Dr Ste 210
Belleville, IL 62226-5373 - Phone
- (618) 767-7700
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085001883 | IL | |
| Physician Assistant | 363A00000X | 085001883 | IL | Primary |
Addresses
Primary practice location
4700 Memorial Dr Ste 210
Belleville, IL 62226-5373
Mailing address
4700 Memorial Dr Ste 210
Belleville, IL 62226-5373
Phone (618) 767-7700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240
4700 Memorial Dr
Belleville, IL 62226-5373
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085001883 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Past | Accepting new patients | |
| Healthcare Physicians of Southern Illinois, PC | Past | Accepting new patients | |
| PC Associates, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Belleville, IL
- NPI 1023034618
-
- Family Medicine Physician
- Dupo, IL
- NPI 1437462637
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maryville, IL
- NPI 1053481630
-
- Critical Access Hospital
- Sparta, IL
- NPI 1548216476
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
-
- Home Health Agency
- Saint Louis, MO
- NPI 1811432180
-
- Home Health Agency
- Saint Louis, MO
- NPI 1326077199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1023088655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR STE 210",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-767-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR STE 210",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-767-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "LANCE",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085001883",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085001883",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4700 Memorial Dr Ste 210",
"city": "Belleville",
"state": "IL",
"country_code": "US",
"postal_code": "622265373",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.