Individual provider Active NPI

Jenny Lam, M.D.

  • Cardiovascular Disease Physician
  • Nesconset, NY
National Provider Identifier
1679849764
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
272532 Issued in NY
Practice address
61 Southern Blvd
Nesconset, NY 11767-1089
Phone
(631) 659-1800
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 272532 NY Primary

Addresses

Primary practice location

61 Southern Blvd
Nesconset, NY 11767-1089

Mailing address

61 Southern Blvd
Nesconset, NY 11767-1089
Phone (631) 659-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180425000575 NY Practitioner - Cardiovascular Disease (Cardiology) 6507150232 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York Medical College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Ekg Interpretation, P. C.Group PAC ID 2466345103, 57 clinicians
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 465-6225

1916 Union Blvd
Bay Shore, NY 11706-7921
Phone (631) 666-2290

61 Southern Blvd
Nesconset, NY 11767-1089
Phone (631) 659-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272532NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince May 1, 2018 Accepting new patients
North Shore-Lij Medical PC Cardiovascular Disease CurrentSince Dec 9, 2019 Accepting new patients
Cardiac Ekg Interpretation, P. C. Cardiovascular Disease CurrentSince Aug 14, 2018 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince May 1, 2018 Accepting new patients

Locations

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

300 Community Dr
Manhasset, NY 11030

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

61 Southern Blvd
Nesconset, NY 11767
Phone (631) 659-1700

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1679849764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671089",
            "telephone_number": "631-659-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671089",
            "telephone_number": "631-659-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "JENNY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "272532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.