Active NPI
Phoebe C. Tam, PA
- Physician Assistant
- Bayside, NY
National Provider Identifier
1326136227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 009080
- Practice address
- 2383 Bell Blvd
Bayside, NY 11360-2053 - Phone
- (718) 423-0200
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 009080 | NY | Primary |
Addresses
Primary practice location
2383 Bell Blvd
Bayside, NY 11360-2053
Mailing address
23-83 Bell Blvd.
Dermatology Center
Bayside, NY 11360
Phone (718) 423-0200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009080 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1326136227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23-83 BELL BLVD.",
"address_2": "DERMATOLOGY CENTER",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11360",
"telephone_number": "718-423-0200",
"fax_number": "718-423-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2383 BELL BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113602053",
"telephone_number": "718-423-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "PHOEBE",
"middle_name": "C.",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "009080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.