Individual provider Active NPI

Nghi My Lac, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1689914426
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1700 S Broad St Apt 201
Philadelphia, PA 19145-2340
Phone
(215) 685-1800
Fax
(215) 683-1815
NPI assigned
Feb 14, 2013
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

1700 S Broad St Apt 201
Philadelphia, PA 19145-2340

Mailing address

1700 S Broad St Apt 201
Philadelphia, PA 19145-2340
Phone (215) 685-1800

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
I20161110001591 PA Practitioner - Physician Assistant 2961621503 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Sep 19, 2016 Accepting new patients
Einstein Practice Plan Inc CurrentSince Sep 19, 2016 Accepting new patients

Locations

5401 Old York Rd
Ste 4
Philadelphia, PA 19141
Phone (215) 456-6990

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

Interoperability endpoints

  • Direct secure messaging: nghi.lac@pdphahs.eclinicaldirectplus.com

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, 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": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1689914426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S BROAD ST APT 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452340",
            "telephone_number": "215-685-1800",
            "fax_number": "215-683-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S BROAD ST APT 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452340",
            "telephone_number": "215-685-1800",
            "fax_number": "215-683-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAC",
        "first_name": "NGHI",
        "middle_name": "MY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "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.