Lily Fong Lam, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38269 Issued in CA

Practice address

20996 Redwood Rd
Castro Valley, CA 94546-5918

Phone

(510) 537-0272

NPI assigned

Nov 12, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Columbia University College of Physicians and Surgeons, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800
  NPD
• Physical Therapy Innovations, Inc.

  • Physical Therapist
  • Oakland, CA
  • NPI 1710021993
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1053698514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20996 REDWOOD RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465918",
            "telephone_number": "510-537-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20996 REDWOOD RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465918",
            "telephone_number": "510-537-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "LILY",
        "middle_name": "FONG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-12",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT38269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Rd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949033308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faruqa Shariff Ladha, M.D.
• Anthony Laglia, M.D.
• Mei Lung Liang Lahey, LAC OMD QME
• Hoa Vincent Lai, DDS
• Lisa Lai, OTR/L
• Crystal Landa, LMFT
• Nicole Landon
• Carolyn Langer, DDS
• Sarah Julie Lara
• Gretchen Largusa, DPT

• Physical Therapist in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.