NPIMap

Individual provider Active NPI

Lakedra S. Pam, M.D.

  • Obstetrics & Gynecology Physician
  • Boston, MA
National Provider Identifier
1992026983
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
282901 Issued in MA
Practice address
850 Harrison Avenue
Yacc 5
Boston, MA 02118-4001
Phone
(617) 414-2000
Fax
(617) 414-5798
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 202981 MA
Obstetrics & Gynecology Physician 207V00000X 282901 MA Primary

Addresses

Primary practice location

850 Harrison Avenue
Yacc 5
Boston, MA 02118-4001

Mailing address

801 Albany Street
FL G
Boston, MA 02119-3791

Other identifiers 1

IdentifierTypeStateIssuer
110162037AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MA2 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
I20150210000436 LA Practitioner - Obstetrics/Gynecology 8022333277 Reassigns benefits to 1 organization
I20200827001812 MA Practitioner - Obstetrics/Gynecology 8022333277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Vanderbilt University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-2000

720 Harrison Ave
Suite 1105
Boston, MA 02118-2334
Phone (617) 414-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
202981MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
South Boston Community Health Center CurrentSince Sep 1, 2020 Accepting new patients
Lsuhn Billing LLC CurrentSince Dec 1, 2014 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. Obstetrics & Gynecology CurrentSince Aug 24, 2020 Accepting new patients
Lsuhn Billing LLC CurrentSince Dec 1, 2014 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
#5
Boston, MA 02118
Phone (617) 414-2000

801 Albany St
Fl G
Roxbury, MA 02119

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: lpam135245@direct.bmc.masshiway.net

Organizations & group practices 5

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1992026983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVENUE",
            "address_2": "YACC 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAM",
        "first_name": "LAKEDRA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "202981",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "282901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110162037A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.