Nicole Renae Bane

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS018569 Issued in PA

Practice address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Phone

(724) 494-0341

Fax

(210) 292-7868

NPI assigned

May 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Clair Professional Services IncGroup PAC ID 4284672742, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gallagher Hospice, LLC Hospice, Bridgeville, PA, CCN 391778
• St Clair Hospital Hospital, Pittsburgh, PA, CCN 390228

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St Clair Professional Services Inc

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1427270594
  Medicare reassignment Care Compare group NPD
• St Clair Professional Services Inc

  • Radiology Clinic/Center
  • Pittsburgh, PA
  • NPI 1366332934
  NPD
• St Clair Professional Services Inc

  • Pediatrics Physician
  • Pittsburgh, PA
  • NPI 1922772656
  NPD
• St Clair Memorial Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1073587119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gallagher Hospice, LLC

  • Community Based Hospice Care Agency
  • Bridgeville, PA
  • NPI 1891169785
  Care Compare affiliation
• St Clair Memorial Hospital

  • General Acute Care Hospital
  • Pittsburgh, PA
  • NPI 1073587119
  Care Compare affiliation

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1629480462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "fax_number": "210-292-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "724-494-0341",
            "fax_number": "210-292-7868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Locust St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152195114",
            "country_code": "US",
            "telephone_number": "412-232-5533",
            "fax_number": "412-232-5689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANE",
        "first_name": "NICOLE",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT015982",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS018569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasir Ayaz Ayubi, DO
• Lisa Marie Bader, MSW
• Chelseah P Baker, RD
• Kathryn Leann Baker, OTR/L
• Rukayat Balogun, M.D.
• Aneesh Atul Bapodra
• David Martin Barrera, M.D.
• Joseph Marshall Bartle II, PA-C
• Anthony Arockiadoss Basil, IDC
• Erika A. Batten, MS, CCC-SLP

• Internal Medicine Physician in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.