Sophia Lane, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

026115 Issued in NY

Practice address

745 64TH St Ste 2
Brooklyn, NY 11220-4753

Phone

(718) 765-2520

NPI assigned

Nov 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: sophia.lane.p1@direct.mmc.nextgenshare.com

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.

• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment
• MMC Division of Breast Surgery

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1609980846
  Medicare reassignment

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1831793652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 64TH ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204753",
            "telephone_number": "718-765-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 64TH ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204753",
            "telephone_number": "718-765-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 Washington St",
            "address_purpose": "LOCATION",
            "city": "Nyack",
            "state": "NY",
            "postal_code": "109603728",
            "country_code": "US",
            "telephone_number": "845-709-3379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "SOPHIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lane, LMSW
• Erica Lane
• Jzhontavia Lane, L.M.T.
• Matthew Lane, MD
• Maya Lane, RPH
• Stefany Lane
• Ally Laney
• Martina Lanfranchi, LMHC
• Chelsea Lang, PMHNP-BC, APRN, MSN
• Fraida Lang

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.