Individual provider Active NPI

Melanie Ann Lane, MD

  • Family Medicine Physician
  • Surprise, AZ
National Provider Identifier
1720062953
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30590 Issued in AZ
Practice address
17014 W Bell Rd Ste 100
Surprise, AZ 85374-2479
Phone
(623) 866-4484
Fax
(415) 252-7176
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 30590 AZ Primary

Addresses

Primary practice location

17014 W Bell Rd Ste 100
Surprise, AZ 85374-2479

Mailing address

17014 W Bell Rd Ste 100
Surprise, AZ 85374-2479
Phone (623) 866-4484

Other identifiers 2

IdentifierTypeStateIssuer
30590OtherAZLICENSE
Z22506OtherAZMEDICARE GROUP PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040105000225 AZ Practitioner - Family PracticePractitioner - Geriatric PsychiatryPractitioner - Geriatric Medicine 0446159958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iora Senior Health LLC 117 clinicians
Rau Physical Therapy Inc 98 clinicians

Practice addresses (Care Compare)

17014 W Bell Rd
Suite 100
Surprise, AZ 85374-2479
Phone (888) 405-6396

193 E Jefferson St
Frankenmuth, MI 48734-1935

Hospital & facility affiliations

  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC CurrentSince Sep 23, 2019 Accepting new patients
Iora Senior Health, LLC CurrentSince Sep 23, 2019 Accepting new patients
Iora Health, LLC Past Accepting new patients
Arizona Institute of Geriatric Medicine Past Accepting new patients
Iora Health Massachusetts, P.C. Past Accepting new patients
Iora Senior Health, LLC Past Accepting new patients

Locations

3137 W Indian School Rd
Phoenix, AZ 85017
Phone (602) 325-5570

17014 W Bell Rd
Ste 100
Surprise, AZ 85374
Phone (623) 249-7852

101 Tremont St
Fl 6
Boston, MA 02108

Organizations & group practices 10

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 1

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1720062953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17014 W BELL RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742479",
            "telephone_number": "623-866-4484",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17014 W BELL RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742479",
            "telephone_number": "623-866-4484",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "30590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "30590",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "Z22506",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.