NPIMap

Individual provider Active NPI

Craig Phillip Lance, M.D.

  • Diagnostic Radiology Physician
  • Tucumcari, NM
National Provider Identifier
1851680763
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2017-0486 Issued in NM
Practice address
301 E Miel de Luna Ave
Tucumcari, NM 88401-3810
Phone
(800) 841-4236
NPI assigned
Mar 31, 2011
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X MD2017-0486 NM Primary
Vascular & Interventional Radiology Physician 2085R0204X MT210197 PA

Addresses

Primary practice location

301 E Miel de Luna Ave
Tucumcari, NM 88401-3810

Mailing address

PO Box 3212
Indianapolis, IN 46206-3212

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-3113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230706000894 CO Practitioner - Diagnostic RadiologyPractitioner - Nuclear MedicinePractitioner - Interventional Radiology 9335438589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology, Nuclear Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Radiologists, P.C.Group PAC ID 7517959794, 11 clinicians
Parkwest Imaging, L.L.CGroup PAC ID 3173415247, 11 clinicians

Practice addresses (Care Compare)

1619 N Greenwood St
Suite 103
Pueblo, CO 81003-2655
Phone (719) 542-2167

3676 Parker Blvd
Suite 165
Pueblo, CO 81008-2212
Phone (719) 595-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Radiologists, P.C. CurrentSince Jul 1, 2023 Accepting new patients
Parkwest Imaging, L.L.C Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
Radiology Associates Diagnostic Radiology PastSince Jul 1, 2023 Accepting new patients
Advanced Imaging LLC Past Accepting new patients

Locations

1619 N Greenwood St
Ste 103
Pueblo, CO 81003
Phone (719) 542-2167

3676 Parker Blvd
Ste 165
Pueblo, CO 81008
Phone (719) 253-7040

Organizations & group practices 4

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851680763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3212",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MIEL DE LUNA AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013810",
            "telephone_number": "800-841-4236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-3113",
            "fax_number": "216-844-5922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANCE",
        "first_name": "CRAIG",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2017-0486",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MT210197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucumcari, NM

Sources for this page

Verify at the official NPI Registry.