NPIMap

Individual provider Active NPI

Leo William Lane, D.O.

  • Internal Medicine Physician
  • Methuen, MA
National Provider Identifier
1770570426
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
155341 Issued in MA
Practice address
421 Merrimack St
Suite 201
Methuen, MA 01844-5803
Phone
(978) 725-4822
Fax
(978) 725-5277
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 155341 MA Primary

Addresses

Primary practice location

421 Merrimack St
Suite 201
Methuen, MA 01844-5803

Mailing address

421 Merrimack St
Suite 201
Methuen, MA 01844-5803
Phone (978) 725-4822

Other identifiers 15

IdentifierTypeStateIssuer
0400810YPMA01OtherNHANTHEM BCBS
2301962OtherMAAETNA US HEALTH
J21428OtherMABCBS MA
3208621MedicaidMA
49241OtherMAFALLON
50493OtherMAMATTHEW THORNTON
043549868OtherMAUNITED HEALTH
504290OtherMACIGNA HEALTHSOURCE
504290OtherMAHEALTH SOURCE
69499OtherMAHARVARD PILGRIM
043549868OtherMAHCVM
043549868OtherMAPHCS
155341OtherMATUFTS
2301962OtherMAUS HEALTH
9593735010OtherMACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040804001444 MA Practitioner - Internal Medicine 6103897913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Valley Medical Associates PCGroup PAC ID 2769441013, 4 clinicians

Practice addresses (Care Compare)

421 Merrimack St
Suite 201
Methuen, MA 01844-5865
Phone (978) 725-4822

Hospital & facility affiliations

  • Pathways Healthcare Home health agency, Westwood, MA, CCN 227569
  • Accentcare Home Health of Massachusetts Home health agency, Fall River, MA, CCN 227203
  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Elara Caring Home health agency, Newburyport, MA, CCN 227503
  • Pathways Healthcare LLC Home health agency, Londonderry, NH, CCN 307095
  • Holy Family Hospital Hospital, Methuen, MA, CCN 220080
  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029
  • Northeast Rehabilitation Hospital Inpatient rehabilitation facility, Salem, NH, CCN 303026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimack Valley Medical Associates, PC Internal Medicine CurrentSince Jul 26, 1999 Accepting new patients

Locations

421 Merrimack St
Ste 201
Methuen, MA 01844
Phone (978) 725-4822

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJJAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJJAA/Endpoint/EHJJAA

Organizations & group practices 1

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 12

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1770570426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MERRIMACK ST",
            "address_2": "SUITE 201",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445803",
            "telephone_number": "978-725-4822",
            "fax_number": "978-725-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MERRIMACK ST",
            "address_2": "SUITE 201",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445803",
            "telephone_number": "978-725-4822",
            "fax_number": "978-725-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LEO",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "155341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "0400810YPMA01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTH",
            "identifier": "2301962",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J21428",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208621",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "49241",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MATTHEW THORNTON",
            "identifier": "50493",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "043549868",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "504290",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SOURCE",
            "identifier": "504290",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "69499",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCVM",
            "identifier": "043549868",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "043549868",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "155341",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTH",
            "identifier": "2301962",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9593735010",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.