Individual provider Active NPI

Lily Lam, RD, MS

  • Registered Dietitian
  • Marina del Rey, CA
National Provider Identifier
1689294878
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86112541 Issued in CA
Practice address
4640 Admiralty Way # 901
Marina del Rey, CA 90292-6621
Phone
(310) 577-5540
Fax
(310) 577-5616
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86112541 CA Primary

Addresses

Primary practice location

4640 Admiralty Way # 901
Marina del Rey, CA 90292-6621

Mailing address

301 S St Andrews PL Apt 217
Los Angeles, CA 90020-4360
Phone (909) 569-7312

Other practice location 1

301 S St Andrews Pl Apt 217
Los Angeles, CA 90020-4360
Phone (909) 569-7312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211108002381 CA Practitioner - Registered Dietitian Or Nutrition Professional 3274922513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4640 Admiralty Way
Suite 600
Marina del Rey, CA 90292-6638
Phone (424) 314-7760

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86112541CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 1, 2021 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4640 Admiralty Way
Ste 901
Marina del Rey, CA 90292
Phone (310) 557-5540

4640 Admiralty Way
Ste 600
Marina del Rey, CA 90292
Phone (310) 448-7840

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1689294878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S ST ANDREWS PL APT 217",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204360",
            "telephone_number": "909-569-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY # 901",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-577-5540",
            "fax_number": "310-577-5616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S St Andrews Pl Apt 217",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900204360",
            "country_code": "US",
            "telephone_number": "909-569-7312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "LILY",
        "name_prefix": "Miss",
        "credential": "RD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86112541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.