Active NPI
Kathryn Lee Serowka Lane, MD
- MOHS-Micrographic Surgery Physician
- Champaign, IL
National Provider Identifier
1154639508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- 036154202
- Practice address
- 101 W University Ave
Champaign, IL 61820-3981 - Phone
- (217) 366-1248
- Fax
- (217) 366-6100
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | 036154202 | IL | Primary |
| Dermatology Physician | 207N00000X | 036154202 | IL |
Addresses
Primary practice location
101 W University Ave
Champaign, IL 61820-3981
Mailing address
101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1248
Other names 1
- Dr. Kathryn Lee Serowka Lane
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | klanemd316253@CarleHieDirect.net | Direct |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Southern California Keck School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1200
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 104 |
| Removal of skin lesions | 120 |
| Removal of skin cancer | 856 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 58 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036154202 | IL | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christie Clinic, PLLC | Dermatology | Current | Accepting new patients |
Locations
101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255
1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684
Interoperability endpoints
- klanemd316253@carlehiedirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1154639508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203981",
"telephone_number": "217-366-1248",
"fax_number": "217-366-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203981",
"telephone_number": "217-366-1248",
"fax_number": "217-366-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "KATHRYN",
"middle_name": "LEE SEROWKA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-20",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "IL",
"license": "036154202",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "036154202",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "klanemd316253@CarleHieDirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "101 W University Ave",
"city": "Champaign",
"state": "IL",
"country_code": "US",
"postal_code": "618203981",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "SEROWKA LANE",
"middle_name": "LEE",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.