Individual provider Active NPI

Grace Lam, RPAC

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1316284458
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010547 Issued in NY
Practice address
1014 Brooklyn Ave
Brooklyn, NY 11203-4003
Phone
(718) 282-7000
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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 010547 NY Primary

Addresses

Primary practice location

1014 Brooklyn Ave
Brooklyn, NY 11203-4003

Mailing address

1131 E 81St St
Brooklyn, NY 11236-4740
Phone (917) 533-2742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180703001944 NY Practitioner - Physician Assistant 3870849995 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 19, 2018 Accepting new patients
Montefiore Medical Center CurrentSince May 19, 2018 Accepting new patients

Locations

200 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 798-5449

111 E 210th St
Bronx, NY 10467

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1316284458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 E 81ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364740",
            "telephone_number": "917-533-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 BROOKLYN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112034003",
            "telephone_number": "718-282-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.