Active NPI
Lane M Lee, DO
- Vascular Surgery Physician
- Marietta, OH
National Provider Identifier
1073600979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 34.005124
- Practice address
- 400 Matthew St Ste 401
Marietta, OH 45750-1656 - Phone
- (740) 374-2252
- Fax
- (740) 374-4974
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 7886 | ND | |
| Vascular Surgery Physician | 2086S0129X | 7886 | ND | |
| Vascular Surgery Physician | 2086S0129X | 34.005124 | OH | Primary |
Addresses
Primary practice location
400 Matthew St Ste 401
Marietta, OH 45750-1656
Mailing address
PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0827289 | Medicaid | OH | |
| 10519 | Medicaid | ND | |
| 3910000637 | Medicaid | WV | |
| P01297083 | Other | OH | RAILROAD MEDICARE - MHCPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Oklahoma State University College of Osteopathic Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
955 Bethesda Dr
FL 1
Zanesville, OH 43701-1873
Phone (740) 454-0804
Hospital & facility affiliations
- Genesis Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 25 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7886 | ND | MD | Vascular Surgery Physician |
| 34.005124 | OH | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Medical Group, LLC | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Genesis Healthcare System | Past | Accepting new patients |
Locations
2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000
955 Bethesda Dr
Fl 1
Zanesville, OH 43701
Phone (740) 454-0804
945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788
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.
-
- Primary Care Clinic/Center
- New Lexington, OH
- NPI 1942503099
-
- General Acute Care Hospital
- Zanesville, OH
- NPI 1598868655
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 4
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": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1073600979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 449",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457500449",
"telephone_number": "740-374-4500",
"fax_number": "740-374-5887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MATTHEW ST STE 401",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457501656",
"telephone_number": "740-374-2252",
"fax_number": "740-374-4974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "LANE",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ND",
"license": "7886",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "ND",
"license": "7886",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OH",
"license": "34.005124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0827289",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10519",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3910000637",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE - MHCPI",
"identifier": "P01297083",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.