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JOHNNY LUM PA-C
NPI 1528016441
Physician Assistant - Medical in Waterbury, CT

Active since May 04, 2006PECOS Enrolled
1389 W MAIN ST, WATERBURY, CT 06708(203) 755-5555(203) 573-8523 Get Directions Write a Review

NPPES record last updated: March 19, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 19, 2026, Dec 22, 2021 (2 updates tracked since 2021).

About Johnny Lum Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNNY LUM PA-C (NPI 1528016441) is an individual medical provider in Waterbury, Connecticut, licensed in Connecticut (000669) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528016441
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJOHNNY LUMCredential: PA-C
Location Address1389 W MAIN STWaterbury, CT 06708-3104
Mailing Address4 Union Ave Apt 20Norwalk, CT 06851-3735 · (203) 919-4635
Phone(203) 755-5555
Fax(203) 573-8523
Sole ProprietorNo
Enumeration DateMay 4, 2006
Last NPPES UpdateMarch 19, 20262 updates tracked since enumeration
NPPES CertifiedMarch 19, 2026
✔ NPI 1528016441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CT · 000669
1389 W MAIN ST, Waterbury, CT 06708
Open in Google Maps ↗

Other Names 1

Other Name (5)Jon Lum Pa-c

Secondary Practice Locations 2

Location 11 Long Wharf Dr Ste 212New Haven, CT 06511-5593 · Phone (203) 624-4208 · Fax (203) 624-4301
Location 29 Washington Ave Ste 202Hamden, CT 06518-3267 · Phone (321) 341-0074

Other Identifiers 1

Medicaid004085636CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johnny Lum Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JUAN FICA M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1389 W MAIN ST, TOWER 2, SUITE 320
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 753-9313
KATHY REIFF
Occupational Therapist (Pediatrics)
1389 W MAIN ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-1474
GREATER WATERBURY ORAL & MAXILLOFACIAL SURGEONS LLC
Dentist (Oral and Maxillofacial Surgery)
1389 W MAIN ST, SUITE 320
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-1427
ENDODONTIC ASSOCIATES OF GREATER WATERBURY, PC
Dentist (Endodontics)
1389 W MAIN ST, SUITE 208
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-1287
CINDY DUNCAN
Speech-Language Pathologist
1389 W MAIN ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-1474
MR. RICHARD POPE PA-C
Physician Assistant (Medical)
1389 W MAIN ST, SUITE120
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 755-5555
SARAH MOREIRA SLP
Speech-Language Pathologist
1389 W MAIN ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-1474
NAUGATUCK VALLEY MRI LLC
Radiology (Diagnostic Radiology)
1389 W MAIN ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 574-1311

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 Johnny Lum's NPI number?

The NPI number for Johnny Lum is 1528016441. It was assigned to this individual provider in the NPPES registry on May 4, 2006. The provider is also known as Jon Lum Pa-C.

Where is Johnny Lum located?

Johnny Lum practices at 1389 W Main St, Waterbury, CT 06708. The listed phone number is (203) 755-5555.

What is Johnny Lum's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Johnny Lum enrolled in Medicare?

Yes. Johnny Lum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Johnny Lum was last updated on March 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.