Michael J Lane (NPI# 1669415188, PAC ID# 4880581339) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1669415188 |
| PAC ID by PECOS | 4880581339 |
| Professional Enrollment ID | I20040301000709 |
| Full Name | Michael J Lane |
| Organization Legal Name | GEM STATE DERMATOLOGY PA |
| Address |
388 E Parkcenter Blvd Boise ID 83706-3942 |
| Phone Number | 2084249101 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2001 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6901700269 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 388 E Parkcenter Blvd, Boise, ID 83706-3942 | 2084249101 | GEM STATE DERMATOLOGY PA |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_047_overall | Care Plan | 89% | |
| MIPS_EC_047_overall | Care Plan | 89% |
| Organization Legal Name | GEM STATE DERMATOLOGY PA |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly H Wolf | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Deedra K Meyers | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Jaclyn Golus | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Steven M Mings | Dermatology | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Street Address |
388 E PARKCENTER BLVD |
| City | BOISE |
| State | ID |
| Zip | 83706-3942 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly H Wolf | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Deedra K Meyers | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Jaclyn Golus | Physician Assistant | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Steven M Mings | Dermatology | Gem State Dermatology Pa | 388 E Parkcenter Blvd, Boise, ID 83706-3942 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharon L Saul | Clinical Social Worker | 3350 Americiana Blvd, Suite 210b, Boise, ID 83706 | |
| Afshin Mofid | Chiropractic | 880 N Curtis Rd, Boise, ID 83706-1306 | |
| James W Kranz | Chiropractic | 910 N Curtis Rd, Boise, ID 83706-1308 | |
| Kenneth C Stratton Jr. | Certified Registered Nurse Anesthetist (crna) | Boise Anesthesia, Pa | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Kyle P Noorlander | Certified Registered Nurse Anesthetist (crna) | Boise Anesthesia, Pa | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Robert L Petersen | Hospitalist | Saint Alphonsus Regional Medical Center Inc | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Brett E Curley | Certified Registered Nurse Anesthetist (crna) | Boise Anesthesia, Pa | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Dianna Lee Binnion | Emergency Medicine | Cep America LLC | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Charles M Reynolds | Emergency Medicine | Cep America LLC | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Shane Kenneth Marshall | Emergency Medicine | Cep America LLC | 1055 N Curtis Rd, Boise, ID 83706-1309 |
| Find all physicians in zip 83706 | |||
| City | BOISE |
| Zip Code | 83706 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BOISE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Michael J Lane.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.