Individual provider Active NPI

Alex Nghia Lam

  • Psychiatric/Mental Health Nurse Practitioner
  • Largo, FL
National Provider Identifier
1104620921
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11038621 Issued in FL
Practice address
716 Seminole Blvd Ste C
Largo, FL 33770-3627
Phone
(727) 238-3241
Fax
(727) 238-8402
NPI assigned
Apr 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11038621 FL Primary

Addresses

Primary practice location

716 Seminole Blvd Ste C
Largo, FL 33770-3627

Mailing address

716 Seminole Blvd Ste C
Largo, FL 33770-3627
Phone (727) 238-3241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251104000112 FL Practitioner - Nurse Practitioner 3072003631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians

Practice addresses (Care Compare)

413 W Robertson St
Suite B
Brandon, FL 33511-5014
Phone (813) 999-1516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11038621FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bokhari Medical Consortium Inc CurrentSince Dec 1, 2025 Accepting new patients
Learning to Achieve Wellness Inc Psychiatric/Mental Health CurrentSince Aug 25, 2025 Accepting new patients
Bokhari Medical Consortium Inc PastSince Jan 26, 2025 Accepting new patients

Locations

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

716 Seminole Blvd
Ste C
Largo, FL 33770
Phone (727) 238-3241

716 Seminole Blvd
Largo, FL 33770
Phone (727) 238-3241

200 NE 25th Ave
Ocala, FL 34470

Organizations & group practices 3

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": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1104620921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 SEMINOLE BLVD STE C",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703627",
            "telephone_number": "727-238-3241",
            "fax_number": "727-238-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 SEMINOLE BLVD STE C",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703627",
            "telephone_number": "727-238-3241",
            "fax_number": "727-238-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ALEX",
        "middle_name": "NGHIA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11038621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.