Individual provider Active NPI

Michele Lee Pane, PA-C

  • Physician Assistant
  • Greenwood Village, CO
National Provider Identifier
1225368418
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2896 Issued in CO
Practice address
5400 S Park Terrace Ave Apt 16-104
Greenwood Village, CO 80111-3368
Phone
(303) 525-2833
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2896 CO Primary

Addresses

Primary practice location

5400 S Park Terrace Ave Apt 16-104
Greenwood Village, CO 80111-3368

Mailing address

5400 S Park Terrace Ave Apt 16-104
Greenwood Village, CO 80111-3368
Phone (303) 525-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000653 FL Practitioner - Physician Assistant 3072785625 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thse - Marco Urgent Care LLCGroup PAC ID 8921131475, 19 clinicians

Practice addresses (Care Compare)

40 S Heathwood Dr
Marco Island, FL 34145-5026
Phone (239) 394-8234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2896COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC Physician Assistant CurrentSince Nov 1, 2018 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Nov 1, 2018 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1225368418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S PARK TERRACE AVE APT 16-104",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113368",
            "telephone_number": "303-525-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S PARK TERRACE AVE APT 16-104",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113368",
            "telephone_number": "303-525-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANE",
        "first_name": "MICHELE",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.