Truc Thanh Pham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

049706 Issued in GA

Practice address

3985 Steve Reynolds Blvd
Suite K 102
Norcross, GA 30093-3035

Phone

(678) 367-0390

Fax

(678) 245-3391

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Emory University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• FL HMO D-SNP
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• AL HMO D-SNP
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• TN PPO C-SNP
• AL HMO
• TN PPO
• FL HMO
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• FL HMO C-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3

Interoperability endpoints

• Direct secure messaging: truc.pham.1@21533.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Qcpi-Villagemd, PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment Care Compare group
• Las Palmas Chiropractic/Medical Rehab. Center

  • Multi-Specialty Clinic/Center
  • Norcross, GA
  • NPI 1669743563
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1003808312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 STEVE REYNOLDS BLVD",
            "address_2": "SUITE K 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933035",
            "telephone_number": "678-367-0390",
            "fax_number": "678-245-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 STEVE REYNOLDS BLVD",
            "address_2": "SUITE K 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933035",
            "telephone_number": "678-367-0390",
            "fax_number": "678-245-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TRUC",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844204821A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "52070574-001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844204821B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lan Thanh Pham, DDS
• Maitram Thi Pham, BS.
• Ngan Mai Pham, M.D.
• Nghia Pham, D.C.
• Thao Hieu Pham, PA-C
• Devyn B Phan
• Quyen Phan, DNP
• Sophia Philip, DNP
• Asia Philpot, NP
• Physical Medicine of Norcross

• Family Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.