Individual provider Active NPI

Kelvin Lam

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1891156196
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291114 Issued in CA
Practice address
11615 Chester Ave
Garden Grove, CA 92840-5410
Phone
(714) 487-8325
NPI assigned
Mar 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291114 CA Primary

Addresses

Primary practice location

11615 Chester Ave
Garden Grove, CA 92840-5410

Mailing address

11615 Chester Ave
Garden Grove, CA 92840-5410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161105000135 CA Practitioner - Physical Therapist in Private Practice 2769760115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Global Physical Therapy and WellnessGroup PAC ID 5890103162, 14 clinicians

Practice addresses (Care Compare)

12131 Brookhurst St
Suite B
Garden Grove, CA 92840-2863
Phone (714) 360-8828

Merit-based Incentive Payment System (MIPS)

Final score
16 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
53.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Global Physical Therapy and Wellness Physical Therapy CurrentSince Mar 6, 2022 Accepting new patients
Dynamix Physical Therapy Inc. Physical Therapist CurrentSince Sep 20, 2016 Accepting new patients
Dynamik Rehab Inc Physical Therapist CurrentSince Sep 10, 2024 Accepting new patients
Global Physical Therapy and Wellness Physical Therapist CurrentSince Jul 15, 2021 Accepting new patients

Locations

12131 Brookhurst St
Ste B
Garden Grove, CA 92840
Phone (714) 360-8828

14221 Euclid St
Ste F
Garden Grove, CA 92843
Phone (714) 343-4834

Organizations & group practices 4

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": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1891156196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11615 CHESTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11615 CHESTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405410",
            "telephone_number": "714-487-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "KELVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.