Active NPI
Amy Wingshan Lam, O.D.
- Optometrist
- Mission Viejo, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12879T
- Practice address
- 555 Shops at Mission Viejo
Ste 30 Shops at Mission Viejo
Mission Viejo, CA 92691 - Phone
- (949) 364-4010
- Fax
- (949) 364-4001
- NPI assigned
- Jan 17, 2007
- Last updated
- Dec 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12879T | CA | Primary |
Addresses
Primary practice location
555 Shops at Mission Viejo
Ste 30 Shops at Mission Viejo
Mission Viejo, CA 92691
Mailing address
17609 Wren Dr
Canyon Country, CA 91387-3826
Phone (415) 722-5592
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20000 Rinaldi St
Porter Ranch, CA 91326-4900
Phone (877) 608-0044
5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12879 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 12879T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Doctors Matthew Alpert and Joshua Corben Optometric Corp | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc. | Past | Accepting new patients | |
| Corben Optometry Inc | Optometrist | Past | Accepting new patients |
Locations
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000
Organizations & group practices 6
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
-
- Optometrist
- Newhall, CA
- NPI 1801910096
-
dba Wink Optometry of Westlake
- Optometrist
- Newhall, CA
- NPI 1164079562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1578615910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17609 WREN DR",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913873826",
"telephone_number": "415-722-5592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 SHOPS AT MISSION VIEJO",
"address_2": "STE 30 SHOPS AT MISSION VIEJO",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "92691",
"telephone_number": "949-364-4010",
"fax_number": "949-364-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "AMY",
"middle_name": "WINGSHAN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12879T",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5601 De Soto Ave",
"city": "Woodland Hills",
"state": "CA",
"country_code": "US",
"postal_code": "913676701",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.