Individual provider Active NPI

Brian William Lane, M.D.

  • Emergency Medicine Physician
  • Prineville, OR
National Provider Identifier
1073540118
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD19148 Issued in OR
Practice address
1201 N Elm
Prineville, OR 97754
Phone
(541) 447-6254
NPI assigned
Jun 26, 2006
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD19148 OR Primary

Addresses

Primary practice location

1201 N Elm
Prineville, OR 97754

Mailing address

11436 Brian LN NE
Poulsbo, WA 98370-7919

Other identifiers 1

IdentifierTypeStateIssuer
8385643MedicaidWA

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
I20060320000136 WA Practitioner - Emergency Medicine 6103840426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Creighton University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Sound Emergency Physicians PLLCGroup PAC ID 9234133703, 30 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (360) 337-8800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.1 of 100Reported as group
Quality
72.48
Improvement activities
40
Cost
80.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19148ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
West Sound Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2006 Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

Organizations & group practices 1

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

Hospital & facility affiliations 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1073540118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11436 BRIAN LN NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N ELM",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "97754",
            "telephone_number": "541-447-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD19148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8385643",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prineville, OR

Sources for this page

Verify at the official NPI Registry.