Individual provider Active NPI

Lewis Lane, MD

  • Psychiatry Physician
  • Dana Point, CA
National Provider Identifier
1053452573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A32528 Issued in CA
Practice address
3 Monarch Bay PLZ
105
Dana Point, CA 92629-3440
Phone
(949) 493-0930
Fax
(949) 493-1709
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A32528 CA Primary

Addresses

Primary practice location

3 Monarch Bay PLZ
105
Dana Point, CA 92629-3440

Mailing address

3 Monarch Bay PLZ
105
Dana Point, CA 92629-3440
Phone (949) 493-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 11, 2015 through May 11, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32528CAMDClinical Psychologist
A32528CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053452573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONARCH BAY PLZ",
            "address_2": "105",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293440",
            "telephone_number": "949-493-0930",
            "fax_number": "949-493-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MONARCH BAY PLZ",
            "address_2": "105",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293440",
            "telephone_number": "949-493-0930",
            "fax_number": "949-493-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A32528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

Verify at the official NPI Registry.