NPIMap

Individual provider Active NPI

Amy Diem Lai

  • Physician Assistant
  • Camarillo, CA
National Provider Identifier
1750958161
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4005 Mission Oaks Blvd Ste a
Camarillo, CA 93012-5156
Phone
(805) 484-7921
Fax
(805) 983-4186
NPI assigned
Jun 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 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

4005 Mission Oaks Blvd Ste a
Camarillo, CA 93012-5156

Mailing address

2801 Cimmaron Ave
Simi Valley, CA 93065-1308
Phone (805) 813-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210719002455 CA Practitioner - Physician Assistant 9638572357 Reassigns benefits to 1 organization
I20250227003796 TX Practitioner - Physician Assistant 9638572357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

3900 Ambassador Dr
Anchorage, AK 99508-5922
Phone (907) 563-2662

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 265-4955

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Feb 1, 2025 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Organizations & group practices 2

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1750958161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 CIMMARON AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651308",
            "telephone_number": "805-813-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 MISSION OAKS BLVD STE A",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125156",
            "telephone_number": "805-484-7921",
            "fax_number": "805-983-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "AMY",
        "middle_name": "DIEM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-06",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.