Individual provider Active NPI

Dakotah Lane, M.D.

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1518303429
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18721 Issued in FL
Practice address
201 N Clyde Morris Blvd
Suite 200
Daytona Beach, FL 32114-2724
Phone
(386) 254-4165
NPI assigned
May 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18721 FL Primary

Addresses

Primary practice location

201 N Clyde Morris Blvd
Suite 200
Daytona Beach, FL 32114-2724

Mailing address

201 N Clyde Morris Blvd
Suite 200
Daytona Beach, FL 32114-2724
Phone (386) 254-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180424002003 WA Practitioner - Family Practice 4183866429 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JS Weill Medical College, Cornell University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

2592 Kwina Rd
Bellingham, WA 98226-9278
Phone 36038404642285

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 734-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18721FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lummi Indian Business Council CurrentSince Mar 17, 2018 Accepting new patients
Lummi Indian Business Council CurrentSince Mar 17, 2018 Accepting new patients

Locations

2592 Kwina Rd
Bellingham, WA 98226
Phone (360) 312-2000

Interoperability endpoints

  • Direct secure messaging: dlane337983@direct.ochin.org

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 3

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": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1518303429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142724",
            "telephone_number": "386-254-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142724",
            "telephone_number": "386-254-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "DAKOTAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "18721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.