Individual provider Active NPI

Mary Wing Sum Tam, MD

  • Ophthalmology Physician
  • Danbury, CT
National Provider Identifier
1053802454
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
80895 Issued in CT
Practice address
57 North St Ste 415
Danbury, CT 06810-5629
Phone
(203) 628-4995
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X T6053 TX
Ophthalmology Physician 207W00000X 80895 CT Primary
Ophthalmology Physician 207W00000X ME163116 FL
Internal Medicine Physician 207R00000X 275696 MA
Ophthalmology Physician 207W00000X 960492 NY

Addresses

Primary practice location

57 North St Ste 415
Danbury, CT 06810-5629

Mailing address

57 North St Ste 415
Danbury, CT 06810-5629

Other identifiers 2

IdentifierTypeStateIssuer
119673400MedicaidFL
1053802454MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231016002533 FL Practitioner - Ophthalmology 9133475668 Reassigns benefits to 3 organizations
I20250527000735 CT Practitioner - Ophthalmology 9133475668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tufts University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refocus Eye Health of Central Connecticut PCGroup PAC ID 5597176834, 38 clinicians

Practice addresses (Care Compare)

57 N St
Suite 415
Danbury, CT 06810-5629
Phone (203) 794-0117

Merit-based Incentive Payment System (MIPS)

Final score
89.49 of 100Reported as group
Quality
75.46
Promoting interoperability
79
Improvement activities
40
Cost
73.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80895CTMDOphthalmology Physician
960492NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 7, 2022 Accepting new patients
Aran Eye Associates PA CurrentSince Sep 19, 2023 Accepting new patients
Aran Eye Associates PA Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Stanley D Braverman MD LLC Ophthalmology CurrentSince Dec 31, 2023 Accepting new patients
Refocus Eye Health of Central Connecticut, P.C. Ophthalmology CurrentSince Jul 1, 2025 Accepting new patients
South Florida Vision Associates, LLC Ophthalmology CurrentSince Oct 28, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Ophthalmology CurrentSince Jul 7, 2022 Accepting new patients
Aran Eye Associates, PA CurrentSince Sep 19, 2023 Accepting new patients
Refocus Eye Health of Central Connecticut, P.C. Ophthalmology CurrentSince Jul 1, 2025 Accepting new patients
Aran Eye Associates PA CurrentSince May 26, 2024 Accepting new patients

Locations

47 Jolley Dr
Bloomfield, CT 06002
Phone (860) 243-3020

57 North St
Ste 415
Danbury, CT 06810
Phone (203) 794-0117

87 Grandview Ave
Ste B
Waterbury, CT 06708
Phone (203) 465-1424

2900 W Cypress Creek Rd
Ste 4
Ft Lauderdale, FL 33309
Phone (954) 676-8446

2900 W Cypress Creek Rd
Ste 1
Ft Lauderdale, FL 33309
Phone (954) 977-0192

2900 W Cypress Creek Rd
Ste 13
Ft Lauderdale, FL 33309
Phone (954) 343-6552

1050 N Federal Hwy
Hollywood, FL 33020
Phone (954) 458-2112

7600 Corporate Center Dr
Miami, FL 33126

290 NW 165th St
Ph 2
North Miami Beach, FL 33169
Phone (305) 949-1600

290 NW 165th St
Ste L100
North Miami Beach, FL 33169
Phone (305) 494-1600

14201 W Sunrise Blvd
#101101
Sunrise, FL 33323
Phone (954) 838-1382

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5303 Harry Hines Blvd
Fl 6
Dallas, TX 75390
Phone (214) 645-2225

800 8th Ave
Ste 306
Fort Worth, TX 76104
Phone (817) 336-1300

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: mary.tam.p6@direct.araneyeassociates.nextgenshare.com
  • Direct secure messaging: mtam@refocus.intellechartdirect.net
  • Direct secure messaging: mary.tam.p1@direct.araneyeassociates.nextgenshare.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1053802454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 NORTH ST STE 415",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105629",
            "fax_number": "203-628-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 NORTH ST STE 415",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105629",
            "telephone_number": "203-628-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "MARY",
        "middle_name": "WING SUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "T6053",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "80895",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME163116",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "275696",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "960492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119673400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053802454",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.