Dr Edward Michael Lane, MD is a medicare enrolled "Otolaryngology" physician in Bridgeport, Connecticut. His current practice location is
4675 Main Street, Bridgeport, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 372-0009.
Dr Edward Michael Lane is licensed to practice in Connecticut (license number 024213) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033140876.
Physician's Profile
| Full Name | Dr Edward Michael Lane |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Location | 4675 Main Street, Bridgeport, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1033140876
- Provider Enumeration Date: 07/06/2006
- Last Update Date: 05/02/2016
Medicare PECOS Information:
- PECOS PAC ID: 3971566001
- Enrollment ID: I20041110000077
Medical Identifiers
Medical identifiers for Dr Edward Michael Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033140876 | NPI | - | NPPES |
| 001242031 | Medicaid | CT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Y00000X | Otolaryngology | 024213 (Connecticut) | 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. Dr Edward Michael Lane allows following entities to bill medicare on his behalf.
| Entity Name | Yale University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205822236
PECOS PAC ID: 9436061736
Enrollment ID: O20031105000015 |
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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. Dr Edward Michael 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 |
|---|
Dr Edward Michael Lane, MD
300 George St, Fl 6,
New Haven, CT 06511-6624
Ph: (203) 785-6610 | Dr Edward Michael Lane, MD
4675 Main Street,
Bridgeport, CT 06606
Ph: (203) 372-0009 |
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