David J. Lane, Ltd. is a medicare enrolled "Audiologist" provider in Mount Vernon, Illinois. Their current practice location is
4117 S Water Tower Pl, Suite C, Mount Vernon, Illinois. You can reach out to their office (for appointments etc.) via phone at
(618) 242-0672.
David J. Lane, Ltd. is licensed to practice in Illinois (license number 147000854) and it also participates in the medicare program. David J. Lane, Ltd.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1821158833.
Healthcare Provider's Profile
| Full Name | David J. Lane, Ltd. |
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| Type | Facility |
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| Speciality | Audiologist |
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| Location | 4117 S Water Tower Pl, Mount Vernon, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1821158833
- Provider Enumeration Date: 12/11/2006
- Last Update Date: 08/30/2010
Medicare PECOS Information:
- PECOS PAC ID: 5991706756
- Enrollment ID: O20070122000133
Medical Identifiers
Medical identifiers for David J. Lane, Ltd. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821158833 | NPI | - | NPPES |
| 354668512001 | Medicaid | IL | |
| 83222520 | Other | IL | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 231H00000X | Audiologist | 147000854 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
David J. Lane, Ltd. acts as a billing entity for following providers:
| Provider Name | David J Lane |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1164472155
PECOS PAC ID: 7618978479
Enrollment ID: I20070122000148 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David J. Lane, Ltd. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
David J. Lane, Ltd.
4117 S Water Tower Pl, Suite C,
Mount Vernon, IL 62864-6293
Ph: (618) 242-0672 | David J. Lane, Ltd.
4117 S Water Tower Pl, Suite C,
Mount Vernon, IL 62864-6293
Ph: (618) 242-0672 |
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