Individual provider Active NPI

Crystal Lam

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1326402975
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A168983 Issued in CA
Practice address
11750 Bird Rd
Miami, FL 33175-3530
Phone
(305) 222-5395
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A168983 CA Primary

Addresses

Primary practice location

11750 Bird Rd
Miami, FL 33175-3530

Mailing address

11750 Bird Rd
Miami, FL 33175-3530
Phone (305) 222-5395

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200828002418 CA Practitioner - Anesthesiology 9739473752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Hawaii John a. Burns School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A168983CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2550 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 529-8000

2175 Rosaline Ave
Ste A
Redding, CA 96001
Phone (530) 225-7400

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

5771 Greenback Ln
Sacramento, CA 95841
Phone (916) 239-2042

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1326402975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 BIRD RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "305-222-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 BIRD RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "305-222-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A168983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.