Individual provider Active NPI

Lori Dianne Kam, O.D.

  • Optometrist
  • Gold River, CA
National Provider Identifier
1609862960
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9015T Issued in CA
Practice address
2248 Sunrise Blvd
Gold River, CA 95670-4342
Phone
(916) 638-3878
NPI assigned
Sep 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9015T CA Primary

Addresses

Primary practice location

2248 Sunrise Blvd
Gold River, CA 95670-4342

Mailing address

103 Tower Rock CT
Folsom, CA 95630-7153
Phone (916) 987-9661

Other identifiers 4

IdentifierTypeStateIssuer
4481310001OtherCACIGNA MEDICARE SUPPLIER N
SD0090150MedicaidCA
4481310002OtherCACIGNA SUPPLIER NO.
SD0090151MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080423000621 CA Practitioner - Optometry 2163500612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lori D Kam and Stephen K Ching OdsGroup PAC ID 3779511951, 2 clinicians

Practice addresses (Care Compare)

2248 Sunrise Blvd
Gold River, CA 95670-4342
Phone (916) 638-3878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9015TCAMDOptometrist
9015CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lori D. Kam and Stephen K. Ching, O.D.S Optometrist CurrentSince Aug 31, 1988 Accepting new patients
Lori D. Kam and Stephen K. Ching, O.D.S Optometrist Past Accepting new patients

Locations

2248 Sunrise Blvd
Gold River, CA 95670
Phone (916) 638-3878

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609862960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TOWER ROCK CT",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956307153",
            "telephone_number": "916-987-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 SUNRISE BLVD",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704342",
            "telephone_number": "916-638-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAM",
        "first_name": "LORI",
        "middle_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9015T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE SUPPLIER N",
            "identifier": "4481310001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0090150",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA SUPPLIER NO.",
            "identifier": "4481310002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0090151",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

Verify at the official NPI Registry.