Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle L Lane

Individual provider Family Nurse Practitioner · NPI 1639730690

Michelle L Lane is a Nurse Practitioner in Syracuse, New York. Qualified in 2017, 9 years ago. Practices with Preventive Medicine Associates LLC, an 8-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and South Carolina.

Years since qualifying
9
Licensed in
NY, SC
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

301 Prospect Ave Fl 6
Syracuse, NY 13203-1807
Phone: (315) 448-5491
Fax: (315) 423-6823
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2220 N Beltline Blvd, Columbia, SC 29204-3907 — (839) 600-9101

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 344578 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 32016 (SC)

Record details

NPI number1639730690
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 21, 2019
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Preventive Medicine Associates Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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