Douglas M Phan, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G51181 Issued in CA

Practice address

1541 Florida Ave Ste 304
Modesto, CA 95350-4439

Phone

(209) 577-3388

Fax

(209) 521-3262

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Otolaryngology

Education

Stanford University School of Medicine, 1982

Medicare assignment

May accept Medicare assignment

Group practices

Advanced Surgical AssociatesGroup PAC ID 2567438849, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
• Direct secure messaging: dphan231597@santaclaravalley.direct-ci.net
• FHIR API: https://api.platform.athenahealth.com/11955/brand/1/csg/1/fhir/r4

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.

• Advanced Surgical Associates

  • Surgery Physician
  • San Jose, CA
  • NPI 1013027150
  Medicare reassignment Care Compare group NPD
• Verity Medical Foundation

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1326312067
  Medicare reassignment NPD
• DCHS Medical Foundation

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1740597368

  Otolaryngology

  NPD
• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  NPD
• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862

  Otolaryngology

  NPD
• First Choice Physician Partners

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892
  NPD
• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)
• Seton Medical Center

  • General Acute Care Hospital
  • Daly City, CA
  • NPI 1679608640
  NPD (past)
• Stanford Hospital and Clinics

  • Clinical Medical Laboratory
  • Palo Alto, CA
  • NPI 1174698468
  NPD (past)
• Blessing Corporate Services Inc

  • Rural Health Clinic/Center
  • Warsaw, IL
  • NPI 1720186265
  NPD (past)
• Blessing Hospital

  • Rural Health Clinic/Center
  • Monroe City, MO
  • NPI 1013683507
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1013073766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST",
            "address_2": "SUITE 322",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012719",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE STE 304",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504439",
            "telephone_number": "209-577-3388",
            "fax_number": "209-521-3262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Broadway St",
            "address_2": "Suite 322",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012719",
            "country_code": "US",
            "telephone_number": "217-223-8400 x7891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G51181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quoc Pham
• Tra V Pham, MD
• Tri Minh Pham, M.D.
• Tuong Van Pham
• Alexander Phan, D.O.
• Oanh Hoang Nguyen Phan, NP-C
• Thevi Phanthalangsy
• Pharmatemp
• Jamie Pheap
• Paveevon Pheap

• Otolaryngology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.