MR. SAMUEL HOUSTON LANE V
NPI 1104628940
Nurse Practitioner - Family in Las Vegas, NV
About Mr. Samuel Houston Lane V NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. SAMUEL HOUSTON LANE V (NPI 1104628940) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (888784) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Samuel Houston Lane V is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Samuel Lane reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Henderson, NV 89052
- Reassigned Medicare billing, Nevada enrollment
- 107 clinicians in this Medicare group
Henderson, NV 89015
- Reassigned Medicare billing, Nevada enrollment
- 161 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 89183 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel Lane's NPI number?
The NPI number for Samuel Lane is 1104628940. It was assigned to this individual provider in the NPPES registry on March 25, 2025.
Where is Samuel Lane located?
Samuel Lane practices at 9785 S Maryland Pkwy Ste 2, Las Vegas, NV 89183. The listed phone number is (702) 474-0077.
What is Samuel Lane's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samuel Lane enrolled in Medicare?
Yes. Samuel Lane is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Samuel Lane's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Lane reassigns Medicare benefits to 2 organizations: Urgent Care Nevada, LLC (Henderson, NV) and Shadow Emergency Physicians PLLC (Henderson, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Lane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Lane accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Samuel Lane as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Samuel Lane was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Samuel Houston Lane V · NPI 1104628940
Family physician in Las Vegas, Nevada. Individual provider, active in the CMS NPPES registry since March 25, 2025.
## Identity
- **NPI:** 1104628940 (Entity type: Individual)
- **Enumerated:** March 25, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 888784 (Nevada)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 9785 S MARYLAND PKWY STE 2, Las Vegas, NV 89183-7124
- **Phone:** (702) 474-0077
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Urgent Care Nevada, LLC (NPI 1134546575, Henderson, NV); Shadow Emergency Physicians PLLC (NPI 1487496998, Henderson, NV) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** November 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104628940) · Data from the CMS NPPES public registry.