TIDA LAM D.O
NPI 1114331204
Family Medicine in Wake Forest, NC
About Tida Lam D.o NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIDA LAM D.O (NPI 1114331204) is an individual family medicine provider in Wake Forest, North Carolina, licensed in Massachusetts (271164) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tida Lam D.o is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Tida Lam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fuquay Varina, NC 27526
- Reassigned Medicare billing, North Carolina enrollment
- 217 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 11
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 27587 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tida Lam's NPI number?
The NPI number for Tida Lam is 1114331204. It was assigned to this individual provider in the NPPES registry on June 17, 2014.
Where is Tida Lam located?
Tida Lam practices at 1964 S Main St, Wake Forest, NC 27587. The listed phone number is (919) 554-0177.
What is Tida Lam's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Tida Lam enrolled in Medicare?
Yes. Tida Lam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tida Lam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tida Lam reassigns Medicare benefits to Avance Care, PA (Fuquay Varina, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tida Lam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tida Lam accept?
Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare and UnitedHealthcare list Tida Lam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tida Lam was last updated on May 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tida Lam, D.O · NPI 1114331204
Family Medicine physician in Wake Forest, North Carolina. Individual provider, active in the CMS NPPES registry since June 17, 2014.
## Identity
- **NPI:** 1114331204 (Entity type: Individual)
- **Enumerated:** June 17, 2014
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 271164 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 1964 S MAIN ST, Wake Forest, NC 27587
- **Phone:** (919) 554-0177 · **Fax:** (919) 554-9277
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Avance Care, PA (NPI 1487845020, Fuquay Varina, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** May 7, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1114331204) · Data from the CMS NPPES public registry.