Individual provider Active NPI

Jennifer Ngai Yen Tam, O.D.

  • Vision Therapy Optometrist
  • La Mesa, CA
National Provider Identifier
1063570992
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
12707T Issued in CA
Practice address
7862 El Cajon Blvd
La Mesa, CA 91942-6712
Phone
(619) 644-6405
Fax
(619) 461-5158
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 12707T CA Primary

Addresses

Primary practice location

7862 El Cajon Blvd
La Mesa, CA 91942-6712

Mailing address

7862 El Cajon Blvd
La Mesa, CA 91942-6712
Phone (619) 644-6405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000807 CA Practitioner - Optometry 7315029899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

8701 Cuyamaca St
Santee, CA 92071-4253
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12707TCAMDVision Therapy Optometrist
12707CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Oct 15, 2012 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Oct 15, 2012 Accepting new patients
M Langford OD Optometric Corporation PastSince Jun 15, 2021 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

7862 El Cajon Blvd
La Mesa, CA 91942
Phone (619) 644-6401

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

8701 Cuyamaca St
Santee, CA 92071
Phone (619) 568-8025

Interoperability endpoints

  • Direct secure messaging: jtam32615@sharphealthcare.direct-ci.com

Organizations & group practices 5

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1063570992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7862 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426712",
            "telephone_number": "619-644-6405",
            "fax_number": "619-644-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7862 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426712",
            "telephone_number": "619-644-6405",
            "fax_number": "619-461-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "JENNIFER",
        "middle_name": "NGAI YEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "12707T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.