LAM NGOC PHAM MD
NPI 1225532823
Obstetrics & Gynecology in Morganton, NC

NPI Status: Active since March 20, 2018

Contact Information

2209 S STERLING ST STE 400
MORGANTON, NC
ZIP 28655
Phone: (828) 580-4661

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  • Individual
  • Male
  • Years of Experience 8
  • Obstetrics & Gynecology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About LAM PHAM

This page provides the complete NPI Profile along with additional information for Lam Pham, a women's health care provider established in Morganton, North Carolina with a medical specialization in Obstetrics & Gynecology and more than 8 years of experience. He graduated from University Of South Alabama College Of Medicine in 2018. The healthcare provider is registered in the NPI registry with number 1225532823 assigned on March 2018. The practitioner's primary taxonomy code is 207V00000X with license number 2023-01128 (NC). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1225532823
Provider Name
LAM NGOC PHAM MD
Gender
Male
Entity Type
Individual
Location Address
2209 S STERLING ST STE 400 MORGANTON, NC 28655
Location Phone
(828) 580-4661
Mailing Address
5221 PARAMOUNT PKWY STE 420 MORRISVILLE, NC 27560
Mailing Phone
(984) 974-2705
Medical School Name
UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
03-20-2018
Last Update Date
08-11-2023
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Women's health care providers like Lam Pham treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
2023-01128
License State
NC
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Complete Silver with Atrium Health - HMO
  • Complete Silver with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Blue Max 70/50 $6700 - PPO
  • Blue Max 90/70 $1500 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3200 - PPO
  • Blue POS 60/40 $6500 - POS
  • Blue POS 70/50 $4550 - POS
  • Blue POS 80/60 $3200 - POS
  • Blue POS Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - POS
  • Blue POS Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - POS
  • Blue POS Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - POS
  • Blue POS Copay (PCP, Specialist, Urgent Care) 80/60 $1000 - POS
  • Signature Blue 80/60 $3200 - POS
  • Signature Blue Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - POS
  • Signature Blue Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - POS
  • Standard Expanded Bronze WellCare - PPO
  • Standard Gold WellCare - PPO
  • Standard Silver WellCare - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Lam Pham is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Lam Pham is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9537539945

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20230815000302

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $16.93 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 28655 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $125.01
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $31.25
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.72
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $16.93
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for LAM NGOC PHAM MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1225532823
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2245103484
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 4 + 5 + 1 + 0 + 3 + 4 + 8 + 4 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1225532823 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1326287780DR. PHILENE MICHELLE KROGEL D.O.
Individual
Obstetrics & Gynecology2209 S STERLING ST STE 400
MORGANTON, NC 28655
(828) 580-4661
1477551026 S R EVANS III M.D.
Individual
Obstetrics & Gynecology2209 S STERLING ST STE 400
MORGANTON, NC 28655
(828) 580-4661
1851351308 RICHARD LARKIN SALSMAN M.D.
Individual
Obstetrics & Gynecology2209 S STERLING ST STE 400
MORGANTON, NC 28655
(828) 580-4661
1255770855DR. CHRISTINE SPRITKE LINCOLN M.D.
Individual
Obstetrics & Gynecology2209 S STERLING ST STE 400
MORGANTON, NC 28655
(828) 580-4661
1528596426DR. JENNA MARIE WINFIELD DO
Individual
Obstetrics & Gynecology2209 S STERLING ST STE 400
MORGANTON, NC 28655
(828) 580-4661

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225532823, enumerated in the NPI registry as an "individual" on March 20, 2018

The provider is located at 2209 S Sterling St Ste 400 Morganton, Nc 28655 and the phone number is (828) 580-4661

The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X

The provider has more than 8 years of experience. He graduated from University Of South Alabama College Of Medicine in 2018.

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Absolute Total. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $125.01 with an average copayment of $31.25 for new patient appointments. Established patients should expect a typical charge of $67.72 and an average copayment of 16.93. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on March 20, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.