Cassidy Marie Lane, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fort Worth, Texas. Her current practice location is
1500 S Main St, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at
(817) 702-3431.
Cassidy Marie Lane is licensed to practice in Texas (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1356046056.
Physician's Profile
| Full Name | Cassidy Marie Lane |
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| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1500 S Main St, Fort Worth, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356046056
- Provider Enumeration Date: 04/03/2023
- Last Update Date: 02/16/2025
Medicare PECOS Information:
- PECOS PAC ID: 9234668948
- Enrollment ID: I20250124002888
Medical Identifiers
Medical identifiers for Cassidy Marie Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1356046056 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207P00000X | Emergency Medicine | V3362 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Cassidy Marie Lane allows following entities to bill medicare on her behalf.
| Entity Name | Integrative Emergency Services Physician Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285922542 PECOS PAC ID: 0749447936 Enrollment ID: O20120130000932 |
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| Entity Name | Primary Health Physicians Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770048704 PECOS PAC ID: 7810237740 Enrollment ID: O20190312003418 |
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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. Cassidy Marie Lane 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 |
Cassidy Marie Lane, 10301 Bridgetown Ln, Crowley, TX 76036-3998 Ph: (903) 312-1686 | Cassidy Marie Lane, 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-3431 |
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