Individual provider Active NPI

Mariela P. Lane, MD

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1194019125
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P9387 Issued in TX
Practice address
200 Lisbon St
El Paso, TX 79905-4604
Phone
(915) 778-9200
NPI assigned
Jun 7, 2011
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L-247668 MA
Internal Medicine Physician 207R00000X P9387 TX Primary

Addresses

Primary practice location

200 Lisbon St
El Paso, TX 79905-4604

Mailing address

200 Lisbon St
El Paso, TX 79905-4604
Phone (915) 778-9200

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160429001425 TX Practitioner - Internal MedicinePractitioner - General Practice 7719147669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Baylor College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-247668MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Internal Medicine Current Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Nov 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
Centro de Salud Familiar la Fe, Inc. PastSince Sep 28, 2021 Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Interoperability endpoints

  • Direct secure messaging: marielalane@tdh.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1194019125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LISBON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799054604",
            "telephone_number": "915-778-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LISBON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799054604",
            "telephone_number": "915-778-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5200",
            "fax_number": "915-215-8640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "MARIELA",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "L-247668",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P9387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.