Individual provider Active NPI

Lane Melgarejo, MD

  • Internal Medicine Physician
  • Napa, CA
National Provider Identifier
1588657308
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52120 Issued in CA
Practice address
2100 Napa Vallejo Hwy.
Napa, CA 94558-6293
Phone
(707) 253-5000
Fax
(323) 254-9026
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A 52120 CA
Internal Medicine Physician 207R00000X 52120 CA Primary

Addresses

Primary practice location

2100 Napa Vallejo Hwy.
Napa, CA 94558-6293

Mailing address

2100 Napa Vallejo Hwy.
Napa, CA 94558-6293
Phone (707) 253-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041203000927 CA Practitioner - General PracticePractitioner - Pathology 2163488842 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52120CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Apr 17, 2016 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Apr 17, 2016 Accepting new patients

Locations

2100 Napa Vallejo Hwy
Napa, CA 94558
Phone (707) 253-5000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1588657308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY.",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586293",
            "telephone_number": "707-253-5000",
            "fax_number": "707-253-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY.",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586293",
            "telephone_number": "707-253-5000",
            "fax_number": "323-254-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELGAREJO",
        "first_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A 52120",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "52120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.