NPIMap

Individual provider Active NPI

Carmen Lam, DO

  • Student in an Organized Health Care Education/Training Program
  • Columbus, OH
National Provider Identifier
1477904837
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
393 E Town St Ste 116
Columbus, OH 43215-4799
Phone
(614) 566-9108
Fax
(614) 566-9110
NPI assigned
Jun 28, 2016
Last updated
May 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Surgery Physician 208600000X 5101022799 MI

Addresses

Primary practice location

393 E Town St Ste 116
Columbus, OH 43215-4799

Mailing address

111 S Grant Ave
Columbus, OH 43215-4701

Other practice location 1

12000 E 12 Mile Rd
Warren, MI 48093-3570
Phone (586) 576-4140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230227000467 CA Practitioner - Surgical Oncology 1850686601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Epic CareGroup PAC ID 5890053094, 54 clinicians

Practice addresses (Care Compare)

3003 Oak Rd
Suite 104
Walnut Creek, CA 94597-4541
Phone (925) 391-2221

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy25
Melanoma (skin cancer) excision14
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Care Single Specialty CurrentSince Dec 1, 2022 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
John Muir Health Past Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Past Accepting new patients
John Muir Health Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients

Locations

2345 Country Hills Dr
Antioch, CA 94509
Phone (925) 418-0278

4721 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 676-2600

3003 Oak Rd
Ste 104
Walnut Creek, CA 94597
Phone (925) 391-2220

Interoperability endpoints

  • Direct secure messaging: clam156526@ehr.johnmuirhealth.com
  • Direct secure messaging: clam635581@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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 5

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1477904837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E TOWN ST STE 116",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154799",
            "telephone_number": "614-566-9108",
            "fax_number": "614-566-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12000 E 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933570",
            "country_code": "US",
            "telephone_number": "586-576-4140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "CARMEN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101022799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.