Individual provider Active NPI

Jennifer Lam, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1497590442
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009986 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 938-4000
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009986 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

32367 Regents Blvd
Union City, CA 94587-4847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240920002151 NY Practitioner - Optometry 2769923416 Reassigns benefits to 1 organization
I20251205000497 CA Practitioner - Optometry 2769923416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Eye Physicians Medical Group,Inc.Group PAC ID 9032162292, 9 clinicians

Practice addresses (Care Compare)

101 S San Mateo Dr
Suite 310
San Mateo, CA 94401-3844
Phone (650) 342-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36055CAMDChiropractor
009986NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Eye Physicians Medical Group,Inc. CurrentSince Sep 21, 2025 Accepting new patients
State of New York Comptrollers Office CurrentSince Jul 8, 2024 Accepting new patients
State of New York Comptrollers Office Optometrist CurrentSince Jul 8, 2024 Accepting new patients

Locations

101 S San Mateo Dr
Ste 310
San Mateo, CA 94401
Phone (650) 235-7522

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

Interoperability endpoints

  • Direct secure messaging: jennier.lam.p1@direct.opt.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1497590442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32367 REGENTS BLVD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945874847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.