Active NPI
Denis M Bane, MD
- Internal Medicine Physician
- Pottsville, PA
National Provider Identifier
1396717898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD011754E
- Practice address
- 106 S Claude a Lord Blvd
Pottsville, PA 17901-3637 - Phone
- (570) 622-4209
- Fax
- (570) 622-1386
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD011754E | PA | Primary |
Addresses
Primary practice location
106 S Claude a Lord Blvd
Pottsville, PA 17901-3637
Mailing address
106 S Claude a Lord Blvd
Pottsville, PA 17901-3637
Phone (570) 622-4209
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000148034 | Other | PA | BLUE SHIELD |
| 0473231 | Other | PA | US HEALTHCARE |
| 110201291 | Other | PA | RAILROAD MEDICARE PBA |
| 0006942510004 | Medicaid | PA | |
| 0064387000 | Other | PA | BLUE CROSS PERSONAL CHOICE |
| 01164201 | Other | PA | CAPITAL BLUE CROSS |
| 020301000 | Other | PA | FEDERAL BLACK LUNG |
| 19928 | Other | PA | GEISINGER HEALTH PLAN |
| 116993900 | Other | PA | FEDERAL EMPLOYEES COMP |
| 01164201 | Other | PA | KEYSTONE |
| 0998130 | Other | PA | KEYSTONE SPECIALIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274140800000",
"number": "1396717898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 S CLAUDE A LORD BLVD",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179013637",
"telephone_number": "570-622-4209",
"fax_number": "570-622-1386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 S CLAUDE A LORD BLVD",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179013637",
"telephone_number": "570-622-4209",
"fax_number": "570-622-1386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANE",
"first_name": "DENIS",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2010-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD011754E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "0000148034",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "0473231",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PBA",
"identifier": "110201291",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006942510004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PERSONAL CHOICE",
"identifier": "0064387000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01164201",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLACK LUNG",
"identifier": "020301000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "19928",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL EMPLOYEES COMP",
"identifier": "116993900",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "01164201",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE SPECIALIST",
"identifier": "0998130",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pottsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.