Individual provider Active NPI

Thy Ai Lam

  • Psychiatric/Mental Health Nurse Practitioner
  • Vista, CA
National Provider Identifier
1083277255
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95016645 Issued in CA
Practice address
550 W Vista Way Ste 407
Vista, CA 92083-5714
Phone
(760) 758-1092
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95036841 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95016645 CA Primary

Addresses

Primary practice location

550 W Vista Way Ste 407
Vista, CA 92083-5714

Mailing address

550 W Vista Way Ste 407
Vista, CA 92083-5714
Phone (760) 758-1092

Other practice location 1

1963 4th Ave
San Diego, CA 92101-2394
Phone (619) 233-3432

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
I20220622000421 CA Practitioner - Nurse Practitioner 8628457694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Systems IncGroup PAC ID 8628019320, 37 clinicians

Practice addresses (Care Compare)

9465 Farnham St
San Diego, CA 92123-1308
Phone (858) 573-2600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems, Inc. Current Accepting new patients
Mental Health Systems, Inc. CurrentSince Mar 8, 2022 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Past Accepting new patients

Locations

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

550 W Vista Way
Ste 407
Vista, CA 92083
Phone (760) 758-1092

Organizations & group practices 4

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1083277255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W VISTA WAY STE 407",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835714",
            "telephone_number": "760-758-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W VISTA WAY STE 407",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835714",
            "telephone_number": "760-758-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1963 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921012394",
            "country_code": "US",
            "telephone_number": "619-233-3432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "THY",
        "middle_name": "AI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95036841",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95016645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.