Travis Lam, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

005480 Issued in AZ

Practice address

3815 E Bell Rd Ste 3100
Phoenix, AZ 85032-2156

Phone

(480) 916-3376

Fax

(602) 835-2698

NPI assigned

Apr 10, 2007

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Oklahoma State University College of Osteopathic Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keith a Mackenzie DO PCGroup PAC ID 1759431539, 3 clinicians

Desert Valley Dermatology PLCGroup PAC ID 7012380751, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: tlam@desertvalley.emadirect.md
• Direct secure messaging: travislam@ad.allscriptsdirect.net

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.

• Desert Valley Dermatology PLC

  • MOHS-Micrographic Surgery Physician
  • Phoenix, AZ
  • NPI 1124739560
  Medicare reassignment Care Compare group NPD Authorized official
• Keith a Mackenzie DO PC

  dba MacKenzie Dermatology

  • Procedural Dermatology Physician
  • Prescott, AZ
  • NPI 1396971958
  Medicare reassignment Care Compare group NPD
• English Dermatology PC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1245659432
  Medicare reassignment NPD
• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1407804115
  Medicare reassignment NPD
• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609291848
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Surprise, AZ
  • NPI 1598112831
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Anthem, AZ
  • NPI 1619428851
  NPD (past)

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

• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park

  • Emergency Care Clinic/Center
  • Litchfield Park, AZ
  • NPI 1265065445

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale

  • Emergency Care Clinic/Center
  • Glendale, AZ
  • NPI 1609408665

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Hospital and Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1982733655
  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Westgate Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1992131734
  Care Compare affiliation

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1841313020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 3100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322156",
            "telephone_number": "480-916-3376",
            "fax_number": "602-835-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "005480",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "58.002277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly M Lam
• Nghi Lam, PHARMD
• Sarah Lam
• Stephany Lam, PHARM D
• Tiffany Ka Yan Lam, PHARMD
• Travis Nguyen Lam
• Lamac House
• Lamanna Chiropractic II PLLC
• Lamanna Family Chiropractic Inc
• Alfred A Lamanna, D.C.

• Dermatology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.