Individual provider Active NPI

Edward Kendrick Lane, PA-C

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1801105077
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3034 Issued in CO
Practice address
4500 E 9TH Ave Ste 450
Denver, CO 80220-3933
Phone
(303) 394-9355
Fax
(303) 388-8564
NPI assigned
Oct 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3034 CO Primary

Addresses

Primary practice location

4500 E 9TH Ave Ste 450
Denver, CO 80220-3933

Mailing address

4900 S Monaco St
#210
Denver, CO 80237-3486
Phone (303) 394-9355

Other identifiers 1

IdentifierTypeStateIssuer
35257229MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edward.lane@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000409 CO Practitioner - Physician Assistant 7012106115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthone Clinic Services - Primary Care LLCGroup PAC ID 7012804446, 45 clinicians

Practice addresses (Care Compare)

10405 Martin Luther King Blvd
Suite 120
Denver, CO 80238-2399
Phone (303) 394-9355

4500 E 9TH Ave
Suite 450
Denver, CO 80220-3933
Phone (303) 393-1027

4809 Argonne St
Denver, CO 80249-6834
Phone (303) 563-2784

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3034COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Navigation LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

5825 Delmonico Dr
Ste 101
Colorado Springs, CO 80919
Phone (706) 315-2523

Interoperability endpoints

  • Direct secure messaging: edward.lane.1@13869.direct.athenahealth.com
  • Direct secure messaging: edward.lane@hca3.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1801105077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-394-9355",
            "fax_number": "303-388-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 E 9TH AVE STE 450",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203933",
            "telephone_number": "303-394-9355",
            "fax_number": "303-388-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "EDWARD",
        "middle_name": "KENDRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35257229",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.lane@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4500 E 9th Ave Ste 450",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802203933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.