Active NPI
NA Yon Nam
- Anesthesiology Physician
- Fontana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 125-054827
- Practice address
- 9961 Sierra Ave
Dept of Anesthesiology
Fontana, CA 92335-6720 - Phone
- (909) 302-4938
- NPI assigned
- Aug 6, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 125-054827 | IL | Primary |
Addresses
Primary practice location
9961 Sierra Ave
Dept of Anesthesiology
Fontana, CA 92335-6720
Mailing address
9961 Sierra Ave
Dept of Anesthesiology
Fontana, CA 92335-6720
Phone (909) 302-4938
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- State University of New York at Buffalo School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
Practice addresses (Care Compare)
1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700
1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125-054827 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700
1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000
10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100
1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500
655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100
2101 E Jefferson St
#4E
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000
6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400
Organizations & group practices 10
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.
-
- Health Maintenance Organization
- Halethorpe, MD
- NPI 1043378656
-
dba Tysons Corner Medical Center Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- McLean, VA
- NPI 1073678637
DC
-
dba Kaiser Permanente Largo Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Largo, MD
- NPI 1366781700
DC
-
dba Kaiser Permanente Gaithersburg Medical Center Ambulatory Surgery Ctr
- Ambulatory Surgical Clinic/Center
- Gaithersburg, MD
- NPI 1497023188
DC
-
dba Kensington Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Kensington, MD
- NPI 1578638425
DC
-
dba So. Baltimore County ASC
- Ambulatory Surgical Clinic/Center
- Halethorpe, MD
- NPI 1942546486
-
dba Kaiser Permanente Annapolis Medical Center
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC
-
dba North Arundel Medical Center
- Health Maintenance Organization
- Glen Burnie, MD
- NPI 1285752121
-
dba Kaiser Permanente Gaithersburg Medical Center
- Health Maintenance Organization
- Gaithersburg, MD
- NPI 1831471713
-
dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1942466149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"address_2": "DEPT OF ANESTHESIOLOGY",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-302-4938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"address_2": "DEPT OF ANESTHESIOLOGY",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-302-4938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAM",
"first_name": "NA YON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "125-054827",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "9961 Sierra Ave",
"city": "Fontana",
"state": "CA",
"country_code": "US",
"postal_code": "923356720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.