Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Michael J Lane, PA-C

Individual provider Physician Assistant · NPI 1669415188

Mr. Michael J Lane, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2001, 25 years ago. Practices with Gem State Dermatology PA, a 6-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
25
Licensed in
ID
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

388 E Parkcenter Blvd
Boise, ID 83706
Phone: (208) 424-9101
Fax: (208) 424-5072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA377 (ID)
Dermatology Physician Taxonomy 207N00000X · Licence M7247 (ID)

Record details

NPI number1669415188
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2006
Last updated in NPPESDecember 5, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Gem State Dermatology Pa — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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