JAKE LANE
NPI 1417506304
Anesthesiologist Assistant in Marietta, GA

Q: What is Jake Lane's NPI number?

The NPI number for Jake Lane is 1417506304. It was assigned to this individual provider in the NPPES registry on September 4, 2019.

Q: What is Jake Lane's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jake Lane was last updated on September 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since September 04, 2019

92.93/100

CMS Quality Rating

677 CHURCH ST NE, MARIETTA, GA 30060(770) 794-0477 Get Directions Write a Review

NPPES record last updated: September 24, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 24, 2019, Sep 4, 2019 (2 updates tracked since 2019).

On this page

About Jake Lane NPPES

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

JAKE LANE (NPI 1417506304) is an individual anesthesiologist assistant in Marietta, Georgia and active in the NPI registry since September 2019. He is affiliated with Wellstar Paulding Medical Center, maintains 3 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1417506304

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameJAKE LANE

Location Address677 CHURCH ST NEMarietta, GA 30060-1101

Mailing Address531 Roselane St Nw Ste 830Marietta, GA 30060-6979 · (770) 794-0477

Phone(770) 794-0477

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateSeptember 4, 2019

Last NPPES UpdateSeptember 24, 20192 updates tracked since enumeration

✔ NPI 1417506304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

677 CHURCH ST NE, Marietta, GA 30060

Open in Google Maps ↗

Secondary Practice Locations 3

Location 18954 Hospital DrDouglasville, GA 30134-2272 · Phone (770) 794-0477

Location 22540 Windy Hill Rd SEMarietta, GA 30067-8605 · Phone (770) 794-0477

Location 3146 Bill Carruth PkwyHiram, GA 30141-3749 · Phone (770) 794-0477

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jake Lane is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921432543

PECOS Enrollment IDI20200107001132

Medicare Billing Reassignments

Medicare enrollment records show Jake Lane reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wellstar Medical Group, LLC

Same address

Neurology

677 CHURCH ST NE
Marietta, GA 30060

Reassigned Medicare billing, Georgia enrollment
3,885 clinicians in this Medicare group

NPI 1083027320 (770) 422-2326

Mak Anesthesia Holdings LLC

2.9 mi

Anesthesiology

1300 RIDENOUR BLVD NW STE 300
Kennesaw, GA 30152

Reassigned Medicare billing, Georgia enrollment
629 clinicians in this Medicare group

NPI 1912452939 (770) 702-1806

Georgia Anesthesiologists, PC

9.3 mi

Anesthesiology

1505 STONEBRIDGE PKWY, SUITE 200
Woodstock, GA 30189

Reassigned Medicare billing, Georgia enrollment
Medicare enrollment name: Georgia Anesthesiologists, P.C.
131 clinicians in this Medicare group

NPI 1740299197 (470) 505-8070

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 3

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.

Anesthesia for lens surgery 00142

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

115 services79 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

41 services35 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110042

Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

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.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

JILLIAN MARIE BLALOCK DO

Emergency Medicine

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

JAMIN GRAHAM MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

SAUMYA S GURBANI MD, PHD

Radiology (Diagnostic Radiology)

677 CHURCH ST NE, ATTN: GME
MARIETTA, GA 30060

Cobb County (770) 793-7742

JULIA PATRICIA KENDRICK

Registered Nurse

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

DR. HALEY PUCKETT LAWHORN MD

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

MRS. RHONDA KIM LEE NP-C

Registered Nurse (Wound Care)

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-7173

DEVIN HORTON CRNA

Nurse Anesthetist, Certified Registered

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 794-0477

BRITNEY ELIZABETH BECKETT

Student in an Organized Health Care Education/Training Program

677 CHURCH ST NE
MARIETTA, GA 30060

Cobb County (770) 793-5000

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 Jake Lane's NPI number?

The NPI number for Jake Lane is 1417506304. It was assigned to this individual provider in the NPPES registry on September 4, 2019.

Where is Jake Lane located?

Jake Lane practices at 677 Church St NE, Marietta, GA 30060. The listed phone number is (770) 794-0477.

What is Jake Lane's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Jake Lane enrolled in Medicare?

Yes. Jake Lane is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jake Lane's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jake Lane reassigns Medicare benefits to 3 organizations: Wellstar Medical Group, LLC (Marietta, GA), Mak Anesthesia Holdings LLC (Kennesaw, GA) and Georgia Anesthesiologists, PC (Woodstock, GA). 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 Jake Lane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jake Lane accept?

Health plans from Alliant Health Plans, Inc. and Oscar Health list Jake 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.

Is Jake Lane affiliated with any hospitals?

According to CMS data, Jake Lane is affiliated with Wellstar Paulding Medical Center.

When was this NPI record last updated?

The NPPES record for Jake Lane was last updated on September 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.