Individual provider Active NPI

Vernissia Tam, MD

  • Colon & Rectal Surgery Physician
  • Frederick, MD
National Provider Identifier
1528344116
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
D0092081 Issued in MD
Practice address
194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone
(240) 575-2526
Fax
(240) 566-7868
NPI assigned
Oct 26, 2011
Last updated
Apr 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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
Colon & Rectal Surgery Physician 208C00000X D0092081 MD Primary

Addresses

Primary practice location

194 Thomas Johnson Dr
Frederick, MD 21702-4679

Mailing address

2946 Woodvalley Dr.
Pikesville, MD 21208
Phone (401) 499-4294

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006000725 MD Practitioner - Colorectal Surgery (Proctology) 6608274634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0092081MDMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Oct 1, 2021 Accepting new patients
Frederick Health Medical Group LLC Current Accepting new patients
Frederick Health Medical Group LLC CurrentSince Oct 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1562 Opossumtown Pike
Ste 302
Frederick, MD 21702

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

504 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 4

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 2

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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1528344116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 WOODVALLEY DR.",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "21208",
            "telephone_number": "401-499-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024679",
            "telephone_number": "240-575-2526",
            "fax_number": "240-566-7868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-5080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "VERNISSIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MD",
            "license": "D0092081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.