Individual provider Active NPI

Nathan Tai Pung Kam, M.D.

  • Gastroenterology Physician
  • San Leandro, CA
National Provider Identifier
1598843351
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G69248 Issued in CA
Practice address
2500 Merced Street
San Leandro, CA 94577-4201
Phone
(510) 454-1000
NPI assigned
Nov 1, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G69248 CA Primary

Addresses

Primary practice location

2500 Merced Street
San Leandro, CA 94577-4201

Mailing address

2500 Merced Street
San Leandro, CA 94577-4201
Phone (510) 454-1000

Other identifiers 1

IdentifierTypeStateIssuer
00G692480MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110126000320 CA Practitioner - Internal MedicinePractitioner - Gastroenterology 7911186713 Reassigns benefits to 1 organization
I20181219000329 HI Practitioner - Gastroenterology 7911186713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Loma Linda University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians

Practice addresses (Care Compare)

111 Raley Blvd
Suite 100
Chico, CA 95928-8351
Phone (530) 332-3986

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
60.52
Promoting interoperability
100
Improvement activities
40
Cost
68.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy115
Upper gastrointestinal (GI) endoscopy for acid reflux114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69248CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Oct 29, 2018 Accepting new patients
Enloe Medical Center Gastroenterology CurrentSince Aug 1, 2021 Accepting new patients
Enloe Medical Center CurrentSince Aug 1, 2021 Accepting new patients

Locations

111 Raley Blvd
Ste 100
Chico, CA 95928
Phone (530) 332-3986

2828 Paa St
Honolulu, HI 96819
Phone (808) 432-5700

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 432-8000

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

Interoperability endpoints

  • Direct secure messaging: nkam60141@enloedirect.org

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, 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1598843351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAM",
        "first_name": "NATHAN",
        "middle_name": "TAI PUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G69248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G692480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.