Individual provider Active NPI

Thomas James Lane

  • Clinical Social Worker
  • Cooperstown, NY
National Provider Identifier
1366961369
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090358 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326
Phone
(607) 547-3456
NPI assigned
Sep 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 61498 TX
Clinical Social Worker 1041C0700X 090358 NY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13915 TX

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326

Mailing address

1 Atwell Rd
1 Atwell Rd, NY 13326
Phone (607) 547-3480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AL, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230911002743 VA Practitioner - Clinical Social Worker 4183088065 Reassigns benefits to 1 organization
I20231026003129 AL Practitioner - Clinical Social Worker 4183088065 Reassigns benefits to 1 organization
I20251009004528 NY Practitioner - Clinical Social Worker 4183088065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

1430 Gadsden Hwy
Suite 116 917
Birmingham, AL 35235-3103
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090358NYMDClinical Social Worker
61498TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Southside Behavioral Health Clinical CurrentSince Jul 24, 2023 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 6, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 6, 2025 Accepting new patients

Locations

1430 Gadsden Hwy
Ste 116917
Birmingham, AL 35235
Phone (208) 623-9050

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

130 North St
Walton, NY 13856
Phone (607) 865-6541

3804 Wilson Blvd
#1318
Arlington, VA 22203

424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936

823 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 447-7601

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1366961369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "1 ATWELL RD",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-12",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "61498",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090358",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.