Individual provider Active NPI

Shawn Lam

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1659055408
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
649 Foulkrod St Unit 301
Philadelphia, PA 19120-2125
Phone
(267) 682-5600
NPI assigned
Jun 12, 2023
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

649 Foulkrod St Unit 301
Philadelphia, PA 19120-2125

Mailing address

649 Foulkrod St Unit 301
Philadelphia, PA 19120-2125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230829004297 PA Practitioner - Physician Assistant 7517320179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Everest Urgent CareGroup PAC ID 0345549267, 10 clinicians

Practice addresses (Care Compare)

2077 Ridge Ave
Suite 4104a
Philadelphia, PA 19121-4108
Phone (267) 817-9800

649 Foulkrod St
Unit 301
Philadelphia, PA 19120-2125
Phone (267) 682-5600

6787 Market St
Suite 101
Upper Darby, PA 19082-1848
Phone (610) 352-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1659055408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 FOULKROD ST UNIT 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 FOULKROD ST UNIT 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202125",
            "telephone_number": "267-682-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.