Individual provider Active NPI

Jonathan Tin Chee Lum, OT

  • Hand Occupational Therapist
  • Fairfield, CA
National Provider Identifier
1073722971
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
3188 Issued in CA
Practice address
2702 Low CT
Fairfield, CA 94534-9771
Phone
(707) 432-2660
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 3188 CA Primary

Addresses

Primary practice location

2702 Low CT
Fairfield, CA 94534-9771

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130810000054 CA Practitioner - Occupational Therapist in Private Practice 8426290008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

1535 River Park Dr
Suite 1000
Sacramento, CA 95815-4601
Phone (916) 286-1000

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 24, 2021 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

9390 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 683-3950

4860 Y St
Ste 1700
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

1535 River Park Dr
Ste 1000
Sacramento, CA 95815
Phone (916) 286-1000

Organizations & group practices 2

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1073722971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 LOW CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349771",
            "telephone_number": "707-432-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "JONATHAN",
        "middle_name": "TIN CHEE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "3188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.