Individual provider Active NPI

Sophie Lam

  • Physician Assistant
  • Chestnut Hill, MA
National Provider Identifier
1609495332
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7965 Issued in MA
Practice address
850 Boylston St
Ste 402
Chestnut Hill, MA 02467-2405
Phone
(617) 732-9300
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA7965 MA Primary

Addresses

Primary practice location

850 Boylston St
Ste 402
Chestnut Hill, MA 02467-2405

Mailing address

850 Boylston St
Ste 402
Chestnut Hill, MA 02467-2405

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Other practice location 2

1495 Hancock St
Quincy, MA 02169-5229
Phone (781) 878-5200

Other names 1

  • Sophie Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810003614 MA Practitioner - Physician Assistant 4688078884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians

Practice addresses (Care Compare)

118 Long Pond Rd
Plymouth, MA 02360-2662
Phone (774) 773-9976

141 Longwater Dr
Suite 201
Norwell, MA 02061-1683

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

1495 Hancock St
Quincy, MA 02169-5229
Phone (781) 878-5200

5 Tarkiln Rd
Kingston, MA 02364-1250
Phone (781) 585-2200

51 Performance Dr
Weymouth, MA 02189-3141
Phone (781) 624-8000

Hospital & facility affiliations

  • South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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.

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1609495332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BOYLSTON ST",
            "address_2": "STE 402",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BOYLSTON ST",
            "address_2": "STE 402",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672405",
            "telephone_number": "617-732-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1495 Hancock St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021695229",
            "country_code": "US",
            "telephone_number": "781-878-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "SOPHIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIE",
            "last_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.