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David Lam, OD

Optometry · Gilroy

NPI 1942613575

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Office
1

Offices

1 location · County of Santa Clara · 1,000 clinicians in this group

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Lam’s office at (408) 885-5000 to ask if they take your plan before you enroll.

California Medical Board record

Licence G14960 · Cancelled

Licence status: Cancelled · since 1968 · New York Medical College.

License has been voluntarily canceled, or the license has been expired for at least five years and has not been renewed. No practice is permitted.

Matched on the licence number without its letter prefix; check the name before relying on it.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%

Original Medicare doctor bills

$5,407

Medicare paid this office $5,407 for 265 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Photography of the retina184$3,127$17
Photography of the retina69$1,704$23
Exam of the internal drainage system of eye16$219$14

Who their Medicare patients are

265 Original Medicare patients in 2024. Average age 71 · Under 65 14% · 85 and older 8% · Women 59% · Also on Medicaid 78% · Health risk score 1.45. Sicker patients than 9 in 10 peers; the typical optometry clinician is at 0.97.

Conditions among them: High blood pressure 75% · Diabetes 75% · Chronic kidney disease 28% · Coronary heart disease 21% · Heart failure 18% · Depression 13% · Atrial fibrillation 11% · COPD 10% · Cancer 8% · Stroke 6% · Dementia 5%.

The office billed $137,469, Medicare allowed $8,966 and paid $5,407; for 288 services of 9 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
2024265288711.45$137,469$5,407
20235697701.40$70,200$2,055
20227092691.29$59,626$1,482
2021222269691.32$101,724$4,523
2020219266691.28$103,287$4,394
2019437522701.33$277,702$14,373
2018528616681.35$332,816$11,264
2017325378681.34$205,188$8,039
2016297361691.42$108,064$7,489
2015437501691.37$102,334$9,613
20141919711.11$6,432$848

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 4 services

Original Medicare services billed in 2023
Photography of the retina36$1,074$26
Exam of the internal drainage system of eye18$224$12
Exam of visual field with extended testing13$206$16
Imaging of optic nerve14$164$12

2022: 2 services

Original Medicare services billed in 2022
Photography of the retina44$1,017$22
Photography of the retina14$20$1

2021: 5 services

Original Medicare services billed in 2021
Photography of the retina165$2,249$14
Photography of the retina43$1,261$26
Exam of visual field with extended testing18$313$17
Exam of the internal drainage system of eye11$199$18
Imaging of retina14$196$14

2020: 5 services

Original Medicare services billed in 2020
Photography of the retina153$2,096$14
Photography of the retina40$844$20
Exam of the internal drainage system of eye28$530$19
Exam of visual field with extended testing13$216$17
Imaging of optic nerve12$152$13

2019: 6 services

Original Medicare services billed in 2019
Photography of the retina304$3,897$13
Established patient complete exam of visual system59$3,880$66
Established patient complete exam of visual system17$1,586$93
Photography of the retina33$1,333$35
Exam of visual field with extended testing29$666$22
Imaging of optic nerve26$475$18

2018: 6 services

Original Medicare services billed in 2018
Photography of the retina431$5,261$12
Established patient complete exam of visual system38$2,016$52
Photography of the retina41$1,763$39
Established patient problem focused exam of visual system14$758$40
Exam of visual field with extended testing22$540$20
Imaging of optic nerve22$389$16

2017: 6 services

Original Medicare services billed in 2017
Photography of the retina242$2,659$11
Established patient complete exam of visual system25$1,702$68
Photography of the retina28$1,373$46
Return visit (30+ min)23$1,173$51
Exam of visual field with extended testing17$253$15
Imaging of optic nerve15$224$15

2016: 6 services

Original Medicare services billed in 2016
Photography of the retina223$3,067$14
Return visit (30+ min)48$2,796$58
Short return visit (20+ min)15$582$29
Exam of visual field with extended testing17$338$19
Imaging of optic nerve11$234$21
Office for the evaluation and management of established patient that may not require presence of healthcare professional17$91$5

2015: 3 services

Original Medicare services billed in 2015
Photography of the retina384$6,447$15
Return visit (30+ min)33$1,817$55
Short return visit (20+ min)21$812$37

Medicaid work

$480,752 in 2024

Medicaid paid $480,752 for 6,080 billed services this clinician did in 2024, up to 103 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Clinic visit/encounter, all-inclusive807$413,932
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit130$58,172
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST691$5,581
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT483$2,867
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient358$82
DETERMINATION REFRACTIVE STATE491$69
Return visit (30+ min)123$49
Pain severity quantified; no pain present (COA) (ONC)572$0
Medication list documented in medical record (COA)719$0
Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)548$0
Most recent systolic blood pressure 130-139 mm Hg (DM) (HTN, CKD, CAD)188$0
Most recent systolic blood pressure greater than or equal to 140 mm Hg (HTN, CKD, CAD) (DM)76$0
Medicaid work by year
20246,08016103$480,752
20235,60213132$409,034
20222,9891086$217,213
20213,1011184$323,640
20202,589690$232,960
20192,1697117$191,260
20182,8087130$206,000
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Clinic visit/encounter, all-inclusive782$386,275
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit28$12,380
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST1,241$7,300
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT1,296$2,796
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient447$74
GONIOSCOPY17$73
DETERMINATION REFRACTIVE STATE664$72
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST39$63
Most recent hemoglobin A1c (HbA1c) level less than 7.0% (DM)129$0
Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)320$0
Most recent systolic blood pressure 130-139 mm Hg (DM) (HTN, CKD, CAD)93$0
Most recent systolic blood pressure greater than or equal to 140 mm Hg (HTN, CKD, CAD) (DM)70$0

2022

Largest Medicaid services in 2022
Clinic visit/encounter, all-inclusive431$208,262
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST745$7,114
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT640$1,751
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient232$68
DETERMINATION REFRACTIVE STATE250$18
Most recent hemoglobin A1c (HbA1c) level less than 7.0% (DM)83$0
Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)232$0
Most recent systolic blood pressure 130-139 mm Hg (DM) (HTN, CKD, CAD)44$0
Most recent systolic blood pressure greater than or equal to 140 mm Hg (HTN, CKD, CAD) (DM)25$0
Most recent diastolic blood pressure less than 80 mm Hg (HTN, CKD, CAD) (DM)307$0

2021

Largest Medicaid services in 2021
Clinic visit/encounter, all-inclusive686$321,484
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT458$1,619
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST618$521
DETERMINATION REFRACTIVE STATE340$16
Most recent hemoglobin A1c (HbA1c) level less than 7.0% (DM)73$0
HEMOGLOBIN A1C LEVEL >9.0%13$0
Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD)272$0
Most recent systolic blood pressure 130-139 mm Hg (DM) (HTN, CKD, CAD)32$0
Most recent systolic blood pressure greater than or equal to 140 mm Hg (HTN, CKD, CAD) (DM)13$0
Most recent diastolic blood pressure less than 80 mm Hg (HTN, CKD, CAD) (DM)359$0
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient237$0

2020

Largest Medicaid services in 2020
Clinic visit/encounter, all-inclusive700$219,833
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST849$12,711
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT327$389
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only16$27
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient331$0
DETERMINATION REFRACTIVE STATE366$0

2019

Largest Medicaid services in 2019
Clinic visit/encounter, all-inclusive565$174,173
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST523$12,804
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST53$3,377
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT504$889
DETERMINATION REFRACTIVE STATE294$16
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient187$0
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit43$0

2018

Largest Medicaid services in 2018
Clinic visit/encounter, all-inclusive645$196,086
OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST359$4,788
OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST91$3,686
FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT1,129$1,082
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit120$200
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient181$157
DETERMINATION REFRACTIVE STATE283$0

Drugs they prescribed that Part D paid

$15,362

Pharmacies billed $15,362 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 278) in 2024. At or below the middle of the specialty; the typical optometry clinician is at 0%.

228 generic and 50 brand-name prescriptions · $15,362 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Latanoprost133$2,203$17
Travoprost11$1,001$91
Timolol Maleate34$333$10
Brimonidine16$268$17
Dorzolamide-Timolol14$195$14
See all 6 drugs
Every Part D drug this clinician prescribed
Latanoprost133$2,203$17
Travoprost11$1,001$91
Timolol Maleate34$333$10
Brimonidine16$268$17
Dorzolamide-Timolol14$195$14
Ketorolac Tromethamine14$144$10

Year by year

Part D prescribing by year
2024278650% (0)18%$15,362
2023253610% (0)17%$13,593
2022217620% (0)22%$18,799
2021233610% (0)28%$25,093
2020240620% (0)34%$26,315
2019234570% (0)33%$30,476
2018249610% (0)37%$27,701
2017233520% (0)30%$20,651
2016186390% (0)23%$10,665
201550210% (0)32%$3,278

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 6 drugs

Part D drugs prescribed in 2023
Latanoprost118$2,955$25
Brimonidine11$2,429$221
Ketorolac Tromethamine24$580$24
Olopatadine19$361$19
Timolol Maleate26$319$12
Dorzolamide-Timolol15$305$20

2022: 5 drugs

Part D drugs prescribed in 2022
Restasis11$5,240$476
Latanoprost100$2,376$24
Timolol Maleate19$327$17
Dorzolamide-Timolol14$256$18
Ketorolac Tromethamine11$193$18

2021: 4 drugs

Part D drugs prescribed in 2021
Restasis34$14,397$423
Latanoprost107$2,684$25
Timolol Maleate34$560$16
Dorzolamide-Timolol11$223$20

2020: 5 drugs

Part D drugs prescribed in 2020
Restasis39$14,956$383
Travatan Z15$3,791$253
Latanoprost96$2,697$28
Dorzolamide-Timolol11$486$44
Timolol Maleate28$331$12

2019: 5 drugs

Part D drugs prescribed in 2019
Restasis35$14,885$425
Travatan Z21$9,847$469
Latanoprost91$2,186$24
Dorzolamide-Timolol13$444$34
Timolol Maleate27$204$8

2018: 6 drugs

Part D drugs prescribed in 2018
Restasis35$12,868$368
Travatan Z14$5,926$423
Fluorometholone16$1,848$116
Latanoprost72$1,501$21
Dorzolamide-Timolol21$372$18
Timolol Maleate28$265$9

2017: 4 drugs

Part D drugs prescribed in 2017
Restasis30$11,141$371
Latanoprost94$1,500$16
Dorzolamide-Timolol15$255$17
Timolol Maleate24$220$9

2016: 4 drugs

Part D drugs prescribed in 2016
Restasis17$4,301$253
Latanoprost86$1,261$15
Timolol Maleate21$265$13
Dorzolamide-Timolol15$250$17

2015: 1 drug

Part D drugs prescribed in 2015
Latanoprost20$314$16

Money from drug and device companies

$89 in 2022

Industry payments by year
202211None$89
201911None$125

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
OptosOct Ophthalmoscope$89
1 payment
  • Meals for Oct Ophthalmoscope · 2022-06-05 · $89
See the published payment
Every published payment
OptosMeals · 2022-06-05Oct Ophthalmoscope$89
See earlier years (2019)

2019: $125

Payments by company in 2019
Shire North American GroupXiidra$125
1 payment
  • Meals for Xiidra · 2019-04-25 · $125

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
80.6 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI
1942613575
Licence
CA 14960California G14960: Cancelled
Trained
State University of New York - State College Optometry, 2014
Gender
Male
More record details
Sole proprietor
Yes
Taxonomy
Federal specialty code 152W00000X (152W00000X)
Mailing address
7475 Camino Arroyo, Gilroy, CA, 95020
NPI first listed
2014-06-11
NPI last updated
2015-06-19

This is when the NPI record was last certified, not a medical board exam.