Individual provider Active NPI

Angela Julienne Fernandez Lam, PT

  • Physical Therapist
  • East Patchogue, NY
National Provider Identifier
1205562790
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048375 Issued in NY
Practice address
285 Sills Rd BLDG 5-6
East Patchogue, NY 11772-4869
Phone
(631) 475-2858
Fax
(631) 475-2886
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048375 NY Primary

Addresses

Primary practice location

285 Sills Rd BLDG 5-6
East Patchogue, NY 11772-4869

Mailing address

285 Sills Rd BLDG 5-6
East Patchogue, NY 11772-4869
Phone (631) 475-2858

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831001922 NY Practitioner - Physical Therapist in Private Practice 6002290616 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince May 20, 2022 Accepting new patients
New York University CurrentSince Jul 31, 2023 Accepting new patients
New York University CurrentSince Jul 31, 2023 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince May 20, 2022 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Feb 6, 2025 Accepting new patients

Locations

285 Sills Rd
Bldg 5-6E
East Patchogue, NY 11772
Phone (631) 475-2858

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

Organizations & group practices 5

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1205562790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 5-6",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-475-2858",
            "fax_number": "631-475-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 5-6",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-475-2858",
            "fax_number": "631-475-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ANGELA JULIENNE",
        "middle_name": "FERNANDEZ",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.