Individual provider Active NPI

Van Lam, M.D.

  • Internal Medicine Physician
  • Carrollton, TX
National Provider Identifier
1689647133
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L0361 Issued in TX
Practice address
1601 W Hebron Pkwy Ste 100
Carrollton, TX 75010-6342
Phone
(972) 426-8675
Fax
(972) 492-4694
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L0361 TX
Internal Medicine Physician 207R00000X L0361 TX Primary

Addresses

Primary practice location

1601 W Hebron Pkwy Ste 100
Carrollton, TX 75010-6342

Mailing address

1601 W Hebron Pkwy Ste 100
Carrollton, TX 75010-6342
Phone (972) 426-8675

Other identifiers 2

IdentifierTypeStateIssuer
041920202OtherTXMEDICAID OTHER
041920201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041124000312 TX Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4183689623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Tulane University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Clinic of North Texas, PLLCGroup PAC ID 9830084540, 212 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1601 W Hebron Pkwy
100 Usmd Carrollton Clin
Carrollton, TX 75010-6342
Phone (972) 426-8675

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0361TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC Internal Medicine CurrentSince Sep 5, 2000 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Sep 5, 2000 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

4333 N Josey Ln
Ste 202
Carrollton, TX 75010
Phone (469) 557-9627

1601 W Hebron Pkwy
Ste 100
Carrollton, TX 75010
Phone (972) 426-8675

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • Direct secure messaging: van.lam@wellmed.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1689647133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W HEBRON PKWY STE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106342",
            "telephone_number": "972-426-8675",
            "fax_number": "972-492-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W HEBRON PKWY STE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106342",
            "telephone_number": "972-426-8675",
            "fax_number": "972-492-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "VAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L0361",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "041920202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041920201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.