Ashlie Tam, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A18370 Issued in CA

Practice address

2 James Way Ste 209
Pismo Beach, CA 93449-4976

Phone

(805) 739-3474

NPI assigned

Apr 20, 2017

Reactivated

Oct 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ashlie Conway Tam Other name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pacific Central Coast Health Centers

  dba Marian Community Clinic

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  Medicare reassignment NPD
• Pacific Central Coast Health Centers

  dba Pismo Beach Pediatric Center

  • Community Health Clinic/Center
  • Pismo Beach, CA
  • NPI 1538618590
  NPD
• Pacific Central Coast Health Centers

  dba Fair Oaks Specialty Center

  • Community Health Clinic/Center
  • Arroyo Grande, CA
  • NPI 1831764117
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  NPD (past)
• Dignity Health

  dba Arroyo Grande Community Hospital

  • General Acute Care Hospital
  • Arroyo Grande, CA
  • NPI 1770659336
  NPD (past)
• Pacific Central Coast Health Centers

  dba Monarch Village Health Center

  • Community Health Clinic/Center
  • Nipomo, CA
  • NPI 1417555061
  NPD (past)

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1942734538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 209",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494976",
            "telephone_number": "805-549-6915",
            "fax_number": "805-549-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 209",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494976",
            "telephone_number": "805-739-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "ASHLIE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "deactivation_date": "2021-09-14",
        "reactivation_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "H89551",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A18370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLIE",
            "last_name": "TAM",
            "middle_name": "CONWAY",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher Stellpflug, DDS
• Steven C Posson, DO, Apmc (The Doctor is In)
• Sarah Victoria Stroemel
• Jennifer Summers, PSY.D.
• Hozair Mohammed Syed, MD
• Christine Louise Tanous
• Bianca Katalina Crystal Taylor
• The San Luis Obispo Hearing Center, Inc
• The Shoe Tree, Inc
• Sharon M Theodore, M.D.

• Pediatrics Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.