Verissa Lam Fong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

15279 Issued in CA

Practice address

3241 S Michigan Ave
#72
Chicago, IL 60616-4201

Phone

(415) 321-9988

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Verissa Lam Optometry CorporationGroup PAC ID 9133508377, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Verissa Lam Optometry Corporation

  • Optometrist
  • San Francisco, CA
  • NPI 1679218671
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1366823221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BATTERY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941114903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "address_2": "#72",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164201",
            "telephone_number": "415-321-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "VERISSA",
        "middle_name": "LAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Fondren, FNP-C
• Nia Denise Foney
• Michal Fonfa, SLP
• Robert Fong II, MD, PHD
• Roger Fong, MPT
• Vicki K Fong, RPH
• Camille Arianne Fonseca, MD,MPH
• Luvianca J. Fonseca, M.D.
• Anika Fonson
• Daniel Arthur Fontaine, L.C.P.C

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.