RUBY WAIYEE TAM (D.O.) – Family Medicine Physician, NPI 1194950303

RUBY WAIYEE TAM (D.O.) is a healthcare provider. based in Crystal, Minnesota. specializing in Family Medicine Physician. They hold the professional credentials D.O.. They hold a License No. 53209 (MN). The NPI Number for RUBY WAIYEE TAM (D.O.) is 1194950303

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
RUBY WAIYEE TAM (D.O.)
NPI
1194950303
Phone
Not provided
Address
5700 BOTTINEAU BLVD
Enumeration Date
18 May 2009
Last Update Date
24 September 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635046500
Graduation Year
2009 (17 years ago)
PAC ID
9335396233
Group Practice PAC ID
0042102956
Professional Enrollment ID
I20120829000066
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for RUBY WAIYEE TAM (D.O.)

  • NovaCare Rehabilitation, 5700, Bottineau Boulevard, Crystal, Hennepin County, Minnesota, 55429, United States

    SUITE 100

    CRYSTAL, MN 554293183

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120829000066IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55429)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042102956View full group profile
NameSpecialtyState
Physician AssistantMN
Family PracticeIA
-MN
-MN
Family PracticeMN
Physician AssistantMN
Family PracticeMN
Physician AssistantMN
Family PracticeMN
Family PracticeMN

Reviews

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Frequently asked questions

Where can patients find RUBY WAIYEE TAM (D.O.)'s NPI?
You can confirm RUBY WAIYEE TAM (D.O.) with NPI 1194950303; it appears in the national provider directory.
Is RUBY WAIYEE TAM (D.O.) currently active in the NPI registry?
CMS-published data lists RUBY WAIYEE TAM (D.O.) as an active registrant.
Can you summarize RUBY WAIYEE TAM (D.O.)'s specialty in plain language?
Clinically, the directory lists RUBY WAIYEE TAM (D.O.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does RUBY WAIYEE TAM (D.O.) practice in Minnesota?
You will see Crystal, Minnesota on file for RUBY WAIYEE TAM (D.O.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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