JACK LANE (DO) – Family Medicine Physician, NPI 1528037793
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JACK LANE (DO)
1262, Wheeler Court, Tulare, Tulare County, California, 93274, United States
TULARE, CA 932740962
Phone:
Type: Mailing
Naval Health Clinic Lemoore, 937, Franklin Avenue, Lemoore, Kings County, California, 93246, United States
LEMOORE, CA 932460001
Phone: (559) 998-4262
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2003-12-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20031205000767 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 93274)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | CA | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 23 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Hospitalist | CA | |
| Pulmonary Disease, Critical Care (Intensivists) | CA | |
| Nurse Practitioner | CA | |
| Emergency Medicine, Internal Medicine | CA | |
| Internal Medicine | CA | |
| General Surgery, Emergency Medicine | NM | |
| H O S P I T A L I S T | CA | |
| Hospitalist, Internal Medicine | CA | |
| Nurse Practitioner | MS | |
| Internal Medicine | CA |
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