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GABRIEL LANE MD
NPI 1649072612
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since March 27, 2025PECOS Enrolled
1402 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 617-2329 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Gabriel Lane Md NPPES

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

GABRIEL LANE MD (NPI 1649072612) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649072612
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameGABRIEL LANECredential: MD
Location Address1402 S GRAND BLVDSaint Louis, MO 63104-1004
Mailing Address1402 S Grand BlvdSaint Louis, MO 63104-1004
Phone(314) 617-2329
Sole ProprietorYes
Enumeration DateMarch 27, 2025
NPPES CertifiedMarch 27, 2025
✔ NPI 1649072612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1402 S GRAND BLVD, Saint Louis, MO 63104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

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.

HALA YAMOUT M.D.
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD, M260
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9853
VICTORIA M WITTGEN
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9870
ADAM BALES D.O.
Anesthesiology
1402 S GRAND BLVD, M260
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9853
ALLISON NICOLE PODSEDNIK GARDNER MD
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3811
DR. KATHERINE JASKOWIAK ROBBINS MD
Pathology (Anatomic Pathology & Clinical Pathology)
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-4547
DR. VIVIAN MAI HATHUC D.O.
Pathology (Anatomic Pathology & Clinical Pathology)
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-4547
TERRY J BUJNAK JR. DO
Orthopaedic Surgery
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3375
MS. FRANCESCA VACCA
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-8694

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 Gabriel Lane's NPI number?

The NPI number for Gabriel Lane is 1649072612. It was assigned to this individual provider in the NPPES registry on March 27, 2025.

Where is Gabriel Lane located?

Gabriel Lane practices at 1402 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 617-2329.

What is Gabriel Lane's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Gabriel Lane enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Gabriel Lane was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.