Individual provider Active NPI

Ngan T Lam, PA, MPH

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1427564848
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111062 Issued in FL
Practice address
1301 Palm Ave
Jacksonville, FL 32207-8432
Phone
(904) 202-7300
Fax
(904) 202-7433
NPI assigned
Dec 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111062 FL Primary

Addresses

Primary practice location

1301 Palm Ave
Jacksonville, FL 32207-8432

Mailing address

PO Box 45278
Jacksonville, FL 32232-5278
Phone (904) 202-2092

Other identifiers 1

IdentifierTypeStateIssuer
024135600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist MD Anderson Cancer Physicians Inc Physician Assistant PastSince Apr 16, 2023 Accepting new patients

Organizations & group practices 1

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1427564848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45278",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322325278",
            "telephone_number": "904-202-2092",
            "fax_number": "904-393-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078432",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "NGAN",
        "middle_name": "T",
        "credential": "PA, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024135600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.