Individual provider Active NPI

Stacy Robin Tam, D.C.

  • Chiropractor
  • Marion, MA
National Provider Identifier
1265506463
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3100 Issued in MA
Practice address
238 Wareham Rd
Marion, MA 02738-1166
Phone
(508) 748-6633
Fax
(508) 748-6649
NPI assigned
Nov 20, 2006
Last updated
Mar 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3100 MA Primary

Addresses

Primary practice location

238 Wareham Rd
Marion, MA 02738-1166

Mailing address

PO Box 148
Marion, MA 02738-0003
Phone (508) 748-6633

Other identifiers 7

IdentifierTypeStateIssuer
AA96361OtherMAHARVARD PILGRAM
7198894OtherMAAETNA
1614142MedicaidMA
711883OtherMAACN NETWORK
711883OtherMAUNITED HEALTHCARE
1265506463OtherMABMC HEALTHNET
Y37172OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070807000679 MA Practitioner - Chiropractic 5395836217 Reassigns benefits to 1 organization
I20081217000435 RI Practitioner - Chiropractic 5395836217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seaside Family Chiropractic, LLCGroup PAC ID 2961564463, 2 clinicians

Practice addresses (Care Compare)

146 Anoka Ave
Barrington, RI 02806-3428
Phone (401) 289-0155

47 Alden Rd
Suite a
Fairhaven, MA 02719-4639
Phone (774) 770-4147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3100MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Family Chiropractic, LLC Chiropractor CurrentSince Sep 10, 2008 Accepting new patients
Malik Enterprises, Inc. Chiropractor Past Accepting new patients

Locations

47 Alden Rd
Ste A
Fairhaven, MA 02719
Phone (774) 770-4147

146 Anoka Ave
Barrington, RI 02806
Phone (401) 289-0155

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1265506463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "MARION",
            "state": "MA",
            "postal_code": "027380003",
            "telephone_number": "508-748-6633",
            "fax_number": "508-748-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 WAREHAM RD",
            "city": "MARION",
            "state": "MA",
            "postal_code": "027381166",
            "telephone_number": "508-748-6633",
            "fax_number": "508-748-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "STACY",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM",
            "identifier": "AA96361",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7198894",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1614142",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN NETWORK",
            "identifier": "711883",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "711883",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "1265506463",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y37172",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.