Individual provider Active NPI

Julie Lam, PA-C

  • Physician Assistant
  • Los Gatos, CA
National Provider Identifier
1346639671
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51768 Issued in CA
Practice address
15055 Los Gatos Blvd Ste 100
Los Gatos, CA 95032-2056
Phone
(408) 356-1000
Fax
(408) 356-1125
NPI assigned
Jan 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51768 CA Primary
Medical Physician Assistant 363AM0700X 51768 CA

Addresses

Primary practice location

15055 Los Gatos Blvd Ste 100
Los Gatos, CA 95032-2056

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

15055 Los Gatos Blvd Ste 240
Los Gatos, CA 95032-2056
Phone (408) 356-1000

Other practice location 2

15055 Los Gatos Blvd Ste 310
Los Gatos, CA 95032-2056
Phone (408) 356-1119

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
I20150106002460 CA Practitioner - Physician Assistant 4587987144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology - Pacific, P.C.Group PAC ID 8325946015, 25 clinicians

Practice addresses (Care Compare)

15055 Los Gatos Blvd
Los Gatos, CA 95032-2056
Phone (408) 356-1000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51768CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology - Pacific, P.C. Current Accepting new patients
Forefront Dermatology - Pacific, P.C. CurrentSince Jun 7, 2022 Accepting new patients
Robert E Beer M D Inc PastSince Jul 25, 2019 Accepting new patients

Locations

15055 Los Gatos Blvd
Ste 100
Los Gatos, CA 95032
Phone (408) 333-9580

15055 Los Gatos Blvd
Ste 310
Los Gatos, CA 95032
Phone (408) 358-7900

15055 Los Gatos Blvd
Ste 240
Los Gatos, CA 95032
Phone (408) 356-1000

267 W Hillcrest Dr
Thousand Oaks, CA 91360
Phone (805) 497-1694

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Organizations & group practices 3

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": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1346639671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15055 LOS GATOS BLVD STE 100",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322056",
            "telephone_number": "408-356-1000",
            "fax_number": "408-356-1125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15055 Los Gatos Blvd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950322056",
            "country_code": "US",
            "telephone_number": "408-356-1000",
            "fax_number": "408-356-1125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15055 Los Gatos Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950322056",
            "country_code": "US",
            "telephone_number": "408-356-1119",
            "fax_number": "408-356-1125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "JULIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51768",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.