Individual provider Active NPI

John William Lane, DPM

  • Podiatrist
  • Maumee, OH
National Provider Identifier
1215936331
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002714L Issued in OH
Practice address
609 Ford St
Maumee, OH 43537-1947
Phone
(419) 893-5539
Fax
(419) 893-6853
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002714L OH Primary

Addresses

Primary practice location

609 Ford St
Maumee, OH 43537-1947

Mailing address

609 Ford St
Maumee, OH 43537-1947
Phone (419) 893-5539

Other identifiers 3

IdentifierTypeStateIssuer
000000135418OtherANTHEM
01359OtherOHPARAMOUNT
0887670MedicaidOH

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000384 OH Practitioner - Podiatry 2961478342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Podiatric Associates of Northwest Ohio, LLCGroup PAC ID 5496720906, 7 clinicians

Practice addresses (Care Compare)

3905 W Sylvania Ave
Toledo, OH 43623-4426
Phone (419) 474-1210

609 Ford St
Maumee, OH 43537-1947
Phone 4198935539228

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue63
Removal of skin lesions90
Removal of nail tissue1939
Removal or shaving of skin growth1160
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2714OHMDClinical Psychologist
36002714LOHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatric Associates of Northwest Ohio, LLC Podiatrist CurrentSince Aug 3, 1992 Accepting new patients
Podiatric Associates of Northwest Ohio, LLC CurrentSince Aug 3, 1992 Accepting new patients
Podiatric Associates of Northwest Ohio, LLC Podiatrist Past Accepting new patients

Locations

609 Ford St
Maumee, OH 43537
Phone (419) 893-5539

3905 W Sylvania Ave
Toledo, OH 43623
Phone (419) 474-1210

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1215936331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 FORD ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371947",
            "telephone_number": "419-893-5539",
            "fax_number": "419-893-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 FORD ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371947",
            "telephone_number": "419-893-5539",
            "fax_number": "419-893-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002714L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000135418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "01359",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0887670",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.