Individual provider Active NPI

Lily Lam, D.O.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1689723249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
217357 Issued in NY
Practice address
413 E 120TH St
La Clinica del Barrio, 1St Floor
New York, NY 10035-3602
Phone
(212) 410-7940
Fax
(212) 410-9236
NPI assigned
Jan 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 217357 NY Primary

Addresses

Primary practice location

413 E 120TH St
La Clinica del Barrio, 1St Floor
New York, NY 10035-3602

Mailing address

413 E 120TH St
La Clinica del Barrio, 1St Floor
New York, NY 10035-3602

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
I20110309000155 NY Practitioner - Family Practice 8123200383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

260 E 188TH St
Bronx, NY 10458-5302
Phone (718) 618-8236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217357NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Jan 30, 2017 Accepting new patients
Union Community Health Center, Inc. CurrentSince Mar 2, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 30, 2017 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
The New York and Presbyterian Hospital Family Medicine Past Accepting new patients

Locations

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

101 Saint Andrews Ln
Fl 1
Glen Cove, NY 11542
Phone (516) 674-1812

300 Community Dr
Manhasset, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: lily.lam.1@18107.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689723249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E 120TH ST",
            "address_2": "LA CLINICA DEL BARRIO, 1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E 120TH ST",
            "address_2": "LA CLINICA DEL BARRIO, 1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353602",
            "telephone_number": "212-410-7940",
            "fax_number": "212-410-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "217357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.