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DR. EDWARD LEWIS LAIN M.D.
NPI 1124079306
Dermatology in Austin, TX

Active since May 13, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
5145 FM 620 N STE B-110, AUSTIN, TX 78732(512) 266-0007(512) 266-0077 Get Directions Write a Review

NPPES record last updated: June 9, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 9, 2020, May 11, 2020, Mar 13, 2020 (3 updates tracked since 2020).

About Dr. Edward Lewis Lain M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EDWARD LEWIS LAIN M.D. (NPI 1124079306) is an individual dermatology provider in Austin, Texas, licensed in Texas (M2684) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Pflugerville, and is a graduate of Baylor College Of Medicine (2002).

NPPES Registry Identity

NPI1124079306
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameDR. EDWARD LEWIS LAINCredential: M.D.
Location Address5145 FM 620 N STE B-110Austin, TX 78732-1815
Mailing Address5145 Fm 620 N Ste B-110Austin, TX 78732-1815 · (512) 266-0007 · Fax (512) 266-0077
Phone(512) 266-0007
Fax(512) 266-0077
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 2002
Enumeration DateMay 13, 2006
Last NPPES UpdateJune 9, 20203 updates tracked since enumeration
NPPES CertifiedJune 9, 2020
✔ NPI 1124079306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in TX · M2684
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
5145 FM 620 N STE B-110, Austin, TX 78732
Open in Google Maps ↗

Secondary Practice Location 1

Location 11601 E Pflugerville Pkwy Ste 1102Pflugerville, TX 78660-6148 · Phone (512) 252-3700

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Moda Health Plan, Inc., Oscar Insurance Company and more.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

Dr. Edward Lewis Lain M.d. 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.

PECOS PAC ID4981607769
PECOS Enrollment IDI20060816000536
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Edward Lain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sanova Dermatology PLLC
11 mi
Dermatology
12319 N MOPAC EXPY STE 100
Austin, TX 78758
  • Reassigned Medicare billing, Texas enrollment
  • 9 clinicians in this Medicare group
NPI 1689957169 (512) 837-3376

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 21

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg J7345
Aminolevulinic acid hcl is a topical gel used to treat certain skin conditions. It works by making affected skin cells more sensitive to light, which is then used to destroy these cells. The gel is applied by a healthcare professional.
6,000 services19 patients
Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
1,481 services234 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
504 services372 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
399 services297 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
192 services161 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
165 services142 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78732 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.03 typical visit price
range $57.88 – $174.00
Typical copayment $22.25 (range $14.47 – $43.50)
Most-billed visit code 99203
Established Patient
$71.95 typical visit price
range $18.88 – $142.23
Typical copayment $17.98 (range $4.72 – $35.55)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
82%1,089 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%2,794 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
0%1,949 patients1/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
82%6,297 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
58%5,515 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
69%1,089 patients3/55-star benchmark: 95%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
56%5,515 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%5,515 patients1/55-star benchmark: 79%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
98%738 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JENNIFER JEAN JORDAN P.A.
Physician Assistant (Medical)
5145 FM 620 N STE B-110
AUSTIN, TX 78732
Travis County (512) 266-0007

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 Edward Lain's NPI number?

The NPI number for Edward Lain is 1124079306. It was assigned to this individual provider in the NPPES registry on May 13, 2006.

Where is Edward Lain located?

Edward Lain practices at 5145 Fm 620 N Ste B-110, Austin, TX 78732. The listed phone number is (512) 266-0007.

What is Edward Lain's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Edward Lain enrolled in Medicare?

Yes. Edward Lain 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 organization bills Medicare for Edward Lain's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edward Lain reassigns Medicare benefits to Sanova Dermatology PLLC (Austin, TX). The 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 Edward Lain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edward Lain accept?

Health plans from Blue Cross and Blue Shield of Texas, Moda Health Plan, Inc., Oscar Insurance Company, Sendero Health Plans, Local Nonprofit and UnitedHealthcare list Edward Lain 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 Edward Lain was last updated on June 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.