NPIMap

Individual provider Active NPI

Travis T Lane, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1689107880
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61132608 Issued in WA
Practice address
5350 Tallman Ave NW Ste 301
Seattle, WA 98107-5902
Phone
(206) 320-3335
Fax
(206) 320-8027
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD61132608 WA Primary

Addresses

Primary practice location

5350 Tallman Ave NW Ste 301
Seattle, WA 98107-5902

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
1689107880MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102002125 WA Practitioner - Internal Medicine 3779971213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

5350 Tallman Ave NW
Suite 301
Seattle, WA 98107-5902
Phone (206) 320-3335

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61132608WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Multi-Specialty Current Accepting new patients
Swedish Health Services Multi-Specialty CurrentSince Aug 2, 2021 Accepting new patients
Swedish Health Services Multi-Specialty CurrentSince Jul 19, 2022 Accepting new patients
Swedish Health Services Internal Medicine CurrentSince Aug 2, 2021 Accepting new patients

Locations

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

5350 Tallman Ave NW
Ste 301
Seattle, WA 98107
Phone (206) 320-3335

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

Organizations & group practices 5

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 6

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1689107880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 TALLMAN AVE NW STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075902",
            "telephone_number": "206-320-3335",
            "fax_number": "206-320-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "TRAVIS",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61132608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689107880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.