Individual provider Active NPI

Nicholas Louis Lamb, PA-C

  • Physician Assistant
  • Sewell, NJ
National Provider Identifier
1992460547
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00660500 Issued in NJ
Practice address
438 Ganttown Rd Ste B8-B9
Sewell, NJ 08080-2341
Phone
(856) 344-7916
Fax
(856) 344-7920
NPI assigned
Nov 8, 2021
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00660500 NJ Primary

Addresses

Primary practice location

438 Ganttown Rd Ste B8-B9
Sewell, NJ 08080-2341

Mailing address

89 Chestnut Ave
Haddon Township, NJ 08108-3406
Phone (215) 275-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211207001595 NJ Practitioner - Physician Assistant 4486044419 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Urgent Care Medicine of New Jersey LLPGroup PAC ID 6002178647, 9 clinicians
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1210 Route 130 N
Suite 1438
Cinnaminson, NJ 08077-3046
Phone (856) 829-0407

627 B Cross Keys Rd
Sicklerville, NJ 08081-9562
Phone (856) 728-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00660500NJMDPhysician Assistant

Organizations & group practices 3

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1992460547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CHESTNUT AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081083406",
            "telephone_number": "215-275-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 GANTTOWN RD STE B8-B9",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802341",
            "telephone_number": "856-344-7916",
            "fax_number": "856-344-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "NICHOLAS",
        "middle_name": "LOUIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00660500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.