Individual provider Active NPI

Emily Tam, O.D.

  • Optometrist
  • Vista, CA
National Provider Identifier
1497161236
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15147 Issued in CA
Practice address
1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone
(760) 631-5000
NPI assigned
Jul 1, 2014
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60594144 WA
Optometrist 152W00000X 15147 CA Primary

Addresses

Primary practice location

1000 Vale Terrace Dr
Vista, CA 92084-5218

Mailing address

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

Other practice location 1

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone (858) 552-8585

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201112001168 CA Order and Referring Only - OptometryPractitioner - Optometry 0345524559

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Community ClinicGroup PAC ID 0042120156, shared by 5 NPIs, 44 clinicians

Practice addresses (Care Compare)

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Norrgard's Optik PastSince Jan 1, 2017 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: emily.tamod.p1@direct.vistacommunityclinic.nextgenshare.com

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

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1497161236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 La Jolla Village Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921610002",
            "country_code": "US",
            "telephone_number": "858-552-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "EMILY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60594144",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.