Individual provider Active NPI

Denise Lam Mah, FNP-BC

  • Family Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1083114508
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008068 Issued in CA
Practice address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone
(909) 396-7812
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Enterostomal Therapy Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WE0900X 95008068 CA
Family Nurse Practitioner 363LF0000X 95008068 CA Primary

Addresses

Primary practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Other practice location 1

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com Direct CITY OF HOPE MEDICAL FOUNDATION

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809005795 CA Practitioner - Nurse Practitioner 5890604532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
78.51
Promoting interoperability
100
Improvement activities
40
Cost
70.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation Multi-Specialty CurrentSince Apr 25, 2021 Accepting new patients
Minghsun Liu, M.D., PC Multi-Specialty CurrentSince Jun 24, 2018 Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

Interoperability endpoints

  • Direct secure messaging: dmah81143@cityofhope.direct-ci.com
  • Direct secure messaging: direct@cityofhope.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1083114508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "909-396-7812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "910103012",
            "country_code": "US",
            "telephone_number": "626-256-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAH",
        "first_name": "DENISE",
        "middle_name": "LAM",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "CA",
            "license": "95008068",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.