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DR. RENEE DIANE LASS DO NPI 1174584445


NPI Information

NPI: 1174584445
Provider Name: DR. RENEE DIANE LASS, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 16D1058983

Address:
4626 PROGRESS DR
SUITE B
DAVENPORT, IA
ZIP 52807
Phone: (563) 359-3736
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DR. Renee Diane Lass, DO is a family medicine in Davenport, IA with 23 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Renee Diane Lass, DO NPI is 1174584445. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4626 PROGRESS DR
SUITE B
DAVENPORT, IA
ZIP 52807-485
Phone: (563) 359-3736
Fax: (563) 359-0153

The NPI 1174584445 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 16D1058983 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of tissue from wounds per session (HCPCS:97597)

The enumeration date for this NPI number is 3/28/2006 and was last updated on 7/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine3589IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H85372MEDICARE UPIN
23444885MEDICAIDIOWA
304386OTHERIOWABLUE CROSS BLUE SHIELD
4I16823MEDICARE ID-TYPE UNSPECIFIEDIOWA
5IB1927MEDICARE PINIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.