NPIMap

Individual provider Active NPI

Jonathan Philip Phi Hai Lam, MD

  • Diagnostic Radiology Physician
  • Deland, FL
National Provider Identifier
1427445626
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME129865 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(386) 943-3160
Fax
(317) 705-5047
NPI assigned
Apr 25, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A168373 CA
Diagnostic Radiology Physician 2085R0202X ME129865 FL Primary

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-3160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL, KY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210604001830 TX Practitioner - Diagnostic Radiology 7810263050 Reassigns benefits to 2 organizations
I20220622003518 FL Practitioner - Diagnostic Radiology 7810263050 Reassigns benefits to 2 organizations
I20230428001645 KY Practitioner - Diagnostic Radiology 7810263050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

1407 Laurel Green CT
Arlington, TX 76005-1351
Phone (407) 200-2355

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

25 S Terry Ave
Suite 220
Orlando, FL 32805-1843
Phone (407) 641-2446

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 764-4000

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

900 Winderley PL
Suite 1100
Maitland, FL 32751-7229
Phone (407) 200-2355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168373CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Radiology Imaging at Lake Mary, LLC CurrentSince Aug 1, 2022 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients

Locations

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jlam694484@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427445626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "386-943-3160",
            "fax_number": "317-705-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "386-943-3160",
            "fax_number": "317-705-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "JONATHAN PHILIP",
        "middle_name": "PHI HAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-25",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A168373",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME129865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.