Active NPI
Grace Hye-Eun Nam, M.D.
- Pediatrics Physician
- Washington, DC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0102955
- Practice address
- 111 Michigan Ave NW Ste M2601
Washington, DC 20010-2916 - Phone
- (888) 884-2327
- Fax
- (301) 244-6301
- NPI assigned
- Apr 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A119425 | CA | |
| Hospitalist Physician | 208M00000X | D0102955 | MD | |
| Pediatrics Physician | 208000000X | D0102955 | MD | Primary |
Addresses
Primary practice location
111 Michigan Ave NW Ste M2601
Washington, DC 20010-2916
Mailing address
54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3311
Other practice location 1
9901 Medical Center Dr
Rockville, MD 20850-3357
Phone (240) 826-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119425 | CA | MD | Clinical Social Worker |
| A119425 | CA | MD | Pediatrics Physician |
| D0102955 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Pediatrics | Current | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Diagnostic Imaging Services | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients | |
| Adventist Healthcare, Inc. | Past | Accepting new patients | |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| JFK Memorial Hospital, Inc. | Past | Accepting new patients | |
| Children'S Hospital | Past | Accepting new patients | |
| Loma Linda University Medical Center | Past | Accepting new patients | |
| Loma Linda University Children'S Hospital | Past | Accepting new patients |
Locations
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
1505 Wilson Ter
Ste 155
Glendale, CA 91206
Phone (818) 500-4055
7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946
25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
11406 Loma Linda Dr
Ste 300
Loma Linda, CA 92354
Phone (909) 558-6277
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697
11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809
26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174
2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- gnam9612@direct.llu.edu
Organizations & group practices 11
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
- Pediatrics Physician
- Loma Linda, CA
- NPI 1275583007
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
-
- General Acute Care Hospital
- Rockville, MD
- NPI 1568468221
-
- Magnetic Resonance Imaging (MRI) Internal Medicine Physician
- Metairie, LA
- NPI 1699793166
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
-
- General Acute Care Hospital
- Indio, CA
- NPI 1477584993
-
- Children's Hospital
- Loma Linda, CA
- NPI 1366866345
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1811946734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756080000000",
"number": "1750606521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54701 FILE NUMBER",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900744701",
"telephone_number": "909-558-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW STE M2601",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "888-884-2327",
"fax_number": "301-244-6301"
}
],
"practiceLocations": [
{
"address_1": "9901 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Rockville",
"state": "MD",
"postal_code": "208503357",
"country_code": "US",
"telephone_number": "240-826-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAM",
"first_name": "GRACE",
"middle_name": "HYE-EUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-05",
"last_updated": "2025-08-25",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A119425",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MD",
"license": "D0102955",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0102955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.