Individual provider Active NPI

Long Yin Tam, PA

  • Physician Assistant
  • El Monte, CA
National Provider Identifier
1225741382
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62454 Issued in CA
Practice address
3401 Aero Jet Ave
El Monte, CA 91731-2801
Phone
(626) 286-8700
NPI assigned
Jan 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA62454 CA Primary

Addresses

Primary practice location

3401 Aero Jet Ave
El Monte, CA 91731-2801

Mailing address

2211 E Orangewood Ave # Unite429
Anaheim, CA 92806-6540
Phone (510) 612-8813

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
I20230420001984 CA Practitioner - Physician Assistant 9234594573 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA62454CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Stewart MD Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ltam2756036@oc.providencedirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1225741382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 E ORANGEWOOD AVE # UNITE429",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928066540",
            "telephone_number": "510-612-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 AERO JET AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312801",
            "telephone_number": "626-286-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "LONG",
        "middle_name": "YIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-03",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.