Individual provider Active NPI

Jeanette M Lam, O.D.

  • Optometrist
  • Carson City, NV
National Provider Identifier
1700928645
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1051 Issued in NV
Practice address
111 W Tenth St
Carson City, NV 89703-5201
Phone
(775) 883-4664
Fax
(775) 883-4750
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA-1801 MD
Optometrist 152W00000X 1051 NV Primary

Addresses

Primary practice location

111 W Tenth St
Carson City, NV 89703-5201

Mailing address

111 W Tenth St
Carson City, NV 89703-5201
Phone (775) 883-4664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080402000696 MD Practitioner - Optometry 6800973728 Reassigns benefits to 2 organizations
I20210210001279 NV Practitioner - Optometry 6800973728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ruckman Eyecare PCGroup PAC ID 6305011818, 3 clinicians

Practice addresses (Care Compare)

111 W Tenth St
Carson City, NV 89703-5201
Phone (775) 883-4664

Merit-based Incentive Payment System (MIPS)

Final score
89.15 of 100Reported as group
Quality
78.3
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA-1801MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Barenburg Optical Service, Inc Optometrist CurrentSince Mar 20, 2017 Accepting new patients
Ruckman Eyecare PC Optometrist CurrentSince Jan 4, 2021 Accepting new patients
Weinstein Eye Associates LLC Optometrist CurrentSince May 23, 2012 Accepting new patients

Locations

100 Park Ave
Baltimore, MD 21201
Phone (410) 727-0285

9051 Baltimore National Pike
Ellicott City, MD 21042
Phone (410) 465-4020

1215 Annapolis Rd
Ste 103
Odenton, MD 21113
Phone (301) 672-2515

5743 Crain Hwy
Uppr Marlboro, MD 20772
Phone (301) 627-4485

3080 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 843-9112

111 W Tenth St
Carson City, NV 89703
Phone (775) 883-4664

Interoperability endpoints

  • Direct secure messaging: jeanette.lam@direct.revolutionehr.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1700928645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W TENTH ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897035201",
            "telephone_number": "775-883-4664",
            "fax_number": "775-883-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W TENTH ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897035201",
            "telephone_number": "775-883-4664",
            "fax_number": "775-883-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "JEANETTE",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA-1801",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.