JACOB LANE
NPI 1992248744
Physician Assistant - Surgical in Des Moines, IA

Q: What is Jacob Lane's NPI number?

The NPI number for Jacob Lane is 1992248744. It was assigned to this individual provider in the NPPES registry on November 28, 2016.

Q: What is Jacob Lane's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Lane was last updated on March 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 November 28, 2016PECOS Enrolled

411 LAUREL ST STE 3250, DES MOINES, IA 50314(515) 643-6400(515) 643-5816 Get Directions Write a Review

NPPES record last updated: March 4, 2021. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Mar 4, 2021, Mar 17, 2018, Nov 29, 2017 (3 updates tracked since 2017).

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About Jacob Lane NPPES

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

JACOB LANE (NPI 1992248744) is an individual surgical provider in Des Moines, Iowa, licensed in Iowa (089244) and active in the NPI registry since November 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mesa.

NPPES Registry Identity

NPI1992248744

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameJACOB LANE

Location Address411 LAUREL ST STE 3250Des Moines, IA 50314-3026

Mailing AddressPo Box 1475Des Moines, IA 50305-1475 · (515) 643-6400 · Fax (515) 643-5816

Phone(515) 643-6400

Fax(515) 643-5816

Sole ProprietorNo

Enumeration DateNovember 28, 2016

Last NPPES UpdateMarch 4, 20213 updates tracked since enumeration

NPPES CertifiedMarch 4, 2021

✔ NPI 1992248744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Licenses✔ Licensed in IA · 089244✔ Licensed in AZ · 860285905

411 LAUREL ST STE 3250, Des Moines, IA 50314

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Secondary Practice Location 1

Location 12945 S Dobson RdMesa, AZ 85202-7941 · Phone (480) 969-4138 ext. 171

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Oscar Insurance Company, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Lane 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.

Areas of Expertise CMS Part B claims

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

120 services107 patients

Other Providers at the Same Location NPPES 19

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

ERIN NICOLE HAVERKAMP PA-C

Physician Assistant