Individual provider Active NPI

Derek J Lam, MD, MPH

  • Otolaryngology Physician
  • Portland, OR
National Provider Identifier
1104938091
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD157387 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
PV-01
Portland, OR 97239-3011
Phone
(503) 494-8135
Fax
(503) 494-4631
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 157387 OR
Otolaryngology Physician 207Y00000X MD157387 OR Primary
Otolaryngology Physician 207Y00000X ML20007565 WA
Pediatric Otolaryngology Physician 207YP0228X 35.095296 OH

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
PV-01
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
PV-01
Portland, OR 97239-3011
Phone (503) 494-8135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000232 OR Practitioner - Otolaryngology 8628229291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Washington School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD157387ORMDOtolaryngology Physician
ML20007565WAMDOtolaryngology Physician
35.095296OHMDPediatric Otolaryngology Physician
157387ORMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Nov 14, 2023 Accepting new patients
University Professional Services CurrentSince Oct 1, 2012 Accepting new patients
University Professional Services CurrentSince Oct 1, 2012 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Nov 14, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
University Professional Services Past Accepting new patients
Oregon Health & Science University Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

3181 SW Sam Jackson Park Rd
#1
Portland, OR 97239
Phone (503) 494-5355

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

Interoperability endpoints

  • Direct secure messaging: dlammd78165@direct.ohsu.edu

Organizations & group practices 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1104938091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "PV-01",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8135",
            "fax_number": "503-494-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "PV-01",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8135",
            "fax_number": "503-494-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "DEREK",
        "middle_name": "J",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OR",
            "license": "157387",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD157387",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "ML20007565",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OH",
            "license": "35.095296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.