Individual provider Active NPI

Sara K Lane, MD

  • Pediatrics Physician
  • Estero, FL
National Provider Identifier
1386806727
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 111008 Issued in FL
Practice address
9260 Estero Park Commons Blvd Ste 100
Estero, FL 33928-6468
Phone
(239) 908-3593
Fax
(239) 908-3597
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 111008 FL Primary

Addresses

Primary practice location

9260 Estero Park Commons Blvd Ste 100
Estero, FL 33928-6468

Mailing address

9260 Estero Park Commons Blvd Ste 100
Estero, FL 33928-6468
Phone (239) 908-3593

Other identifiers 2

IdentifierTypeStateIssuer
14FZ2OtherFLFL BLUE
004015700MedicaidFL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 111008FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lane Pediatrics PA Pediatrics Current Accepting new patients

Locations

9260 Estero Park Commons Blvd
Ste 100
Estero, FL 33928
Phone (239) 908-3593

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1386806727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 ESTERO PARK COMMONS BLVD STE 100",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339286468",
            "telephone_number": "239-908-3593",
            "fax_number": "239-908-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 ESTERO PARK COMMONS BLVD STE 100",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339286468",
            "telephone_number": "239-908-3593",
            "fax_number": "239-908-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "SARA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 111008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "14FZ2",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004015700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.