Active NPI
Alfred Thomas Lane, MD
- Dermatology Physician
- Stanford, CA
National Provider Identifier
1194879981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- A26128
- Practice address
- 900 Blake Wilbur Dr.
W0071
Stanford, CA 94305-5334 - Phone
- (650) 723-6105
- NPI assigned
- Jan 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A26128 | CA | Primary |
Addresses
Primary practice location
900 Blake Wilbur Dr.
W0071
Stanford, CA 94305-5334
Mailing address
1018 Loma Prieta CT
Los Altos, CA 94024-5024
Phone (650) 960-1354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A26128 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanford Health Care | Dermatology | Past | Accepting new patients |
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": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194879981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1018 LOMA PRIETA CT",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940245024",
"telephone_number": "650-960-1354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 BLAKE WILBUR DR.",
"address_2": "W0071",
"city": "STANFORD",
"state": "CA",
"postal_code": "943055334",
"telephone_number": "650-723-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "ALFRED",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A26128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.