Individual provider Active NPI

Amy Jinghong Lam, OD, MS

  • Optometrist
  • Newark, NJ
National Provider Identifier
1417325994
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00669500 Issued in NJ
Practice address
90 Bergen St Ste 6100
Newark, NJ 07103-2425
Phone
(973) 972-2065
Fax
(973) 972-1244
NPI assigned
Sep 14, 2015
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV 008282 NY
Optometrist 152W00000X 27OA00669500 NJ Primary

Addresses

Primary practice location

90 Bergen St Ste 6100
Newark, NJ 07103-2425

Mailing address

90 Bergen St Ste 6100
Newark, NJ 07103-2425
Phone (973) 972-2065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20171114000169 NJ Practitioner - Optometry 2163706151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University HospitalGroup PAC ID 5294636874, 77 clinicians

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-3282

30 Bergen St
Admc 1327
Newark, NJ 07103-1709

30 Bergen St Admc
1327 Attn John Gary Huck
Newark, NJ 07103-1709

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
27OA00669500NJMDOptometrist
TUV 008282NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital CurrentSince Aug 1, 2021 Accepting new patients
Jersey Garden's Optometry P.C. Optometrist CurrentSince Nov 26, 2017 Accepting new patients
University Hospital CurrentSince Aug 1, 2021 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Oct 1, 2026 Accepting new patients
New Jersey Optometry PC Optometrist CurrentSince Oct 3, 2017 Accepting new patients
University Physician Associates of New Jersey Inc PastSince Sep 20, 2022 Accepting new patients

Locations

651 Kapkowski Rd
Ste 1236
Elizabeth, NJ 07201
Phone (908) 249-4047

140 Bergen St
#F1776
Newark, NJ 07103
Phone (973) 972-3282

90 Bergen St
Ste 6100
Newark, NJ 07103
Phone (973) 972-2036

1075 Easton Ave
Ste 1-2
Somerset, NJ 08873
Phone (732) 214-1600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1417325994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 6100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2065",
            "fax_number": "973-972-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 6100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2065",
            "fax_number": "973-972-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "AMY",
        "middle_name": "JINGHONG",
        "name_prefix": "Dr.",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2022-09-15",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV 008282",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00669500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.