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DR. JAMES Z. LAI MD
NPI 1699760447
Ophthalmology in Houston, TX

Active since September 19, 2005PECOS EnrolledAccepts Medicare Assignment
93.42/100
CMS Quality Rating
2855 GRAMERCY ST, HOUSTON, TX 77025(713) 668-6828 Get Directions Write a Review

NPPES record last updated: March 19, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 19, 2021, Apr 19, 2020 (2 updates tracked since 2020).

About Dr. James Z. Lai Md NPPES

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

DR. JAMES Z. LAI MD (NPI 1699760447) is an individual ophthalmology provider in Houston, Texas, licensed in Texas (K8278) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1699760447
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. JAMES Z. LAICredential: MD
Location Address2855 GRAMERCY STHouston, TX 77025-1756
Mailing Address2855 Gramercy St # 400Houston, TX 77025-1697 · (713) 668-6828
Phone(713) 668-6828
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateSeptember 19, 2005
Last NPPES UpdateMarch 19, 20212 updates tracked since enumeration
NPPES CertifiedMarch 19, 2021
✔ NPI 1699760447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in TX · K8278
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Pediatric Ophthalmology and Strabismus SpecialistTaxonomy 207WX0110X · License K8278 (TX)
2855 GRAMERCY ST, Houston, TX 77025
Open in Google Maps ↗

Other Identifiers 1

Medicaid038283001TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Z. Lai Md 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.

PECOS PAC ID9133015332
PECOS Enrollment IDI20100712000140
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.

Areas of Expertise CMS Part B claims 2

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.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
26 services26 patients
Exam to measure eye deviation and range of motion 92060
This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.14
Improvement Activities40
Cost81.47

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.

DEANNA I. PENA-GARCIA OD
Optometrist
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-1828
AVANTI ANESTHESIA, PA
Anesthesiology
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
DR. ROBERT B. WILKINS M.D.
Ophthalmology
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
DR. FIAZ ZAMAN M.D.
Ophthalmology
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
DR. LINDSEY D. HARRIS MD
Ophthalmology (Retina Specialist)
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
DR. WILLIAM H. QUAYLE M.D.
Ophthalmology
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
DR. RICHARD G. URSO M.D.
Ophthalmology
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-6828
HOUSTON OPTIC, PLLC
Durable Medical Equipment & Medical Supplies
2855 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 668-5828

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 James Lai's NPI number?

The NPI number for James Lai is 1699760447. It was assigned to this individual provider in the NPPES registry on September 19, 2005.

Where is James Lai located?

James Lai practices at 2855 Gramercy St, Houston, TX 77025. The listed phone number is (713) 668-6828.

What is James Lai's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is James Lai enrolled in Medicare?

Yes. James Lai 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.

What insurance does James Lai accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list James Lai 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 James Lai was last updated on March 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.