NPIMap

Individual provider Active NPI

Michael Lee Ham, M.D.

  • Ophthalmology Physician
  • Prescott Valley, AZ
National Provider Identifier
1750385647
Registry record updated Jul 16, 2012
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jan 18, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
26357 Issued in AZ
Practice address
2820 N Glassford Hill Rd
Ste 101
Prescott Valley, AZ 86314-2256
Phone
(928) 775-5606
Fax
(928) 772-4999
NPI assigned
Jun 8, 2005
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 26357 AZ Primary

Addresses

Primary practice location

2820 N Glassford Hill Rd
Ste 101
Prescott Valley, AZ 86314-2256

Mailing address

2820 N Glassford Hill Rd
Ste 101
Prescott Valley, AZ 86314-2256
Phone (928) 775-5606

Other identifiers 1

IdentifierTypeStateIssuer
XPY190835MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
K E Express PLLC Ophthalmology Current Accepting new patients

Locations

2820 N Glassford Hill Rd
Prescott Vly, AZ 86314
Phone (928) 771-9000

2820 N Glassford Hill Rd
Ste 100
Prescott Vly, AZ 86314
Phone (520) 775-5606

2820 N Glassford Hill Rd
Ste 101
Prescott Vly, AZ 86314
Phone (928) 771-9000

Organizations & group practices 8

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1750385647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142256",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142256",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "26357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XPY190835",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.