Individual provider Active NPI

Lana Ngoc Pho, M.D.

  • Dermatology Physician
  • Salt Lake City, UT
National Provider Identifier
1013160548
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
51102031205 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-1102
Phone
(801) 587-6340
Fax
(801) 587-6346
NPI assigned
Oct 28, 2008
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 51102031205 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-1102

Mailing address

PO Box 3208
Salt Lake City, UT 84110-3208
Phone (801) 587-6340

Other names 1

  • Dr. Thanh Lan Ngoc Pho Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lanathanh.pho@direct.imail.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20130211000581 UT Practitioner - Dermatology 3779737101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Utah School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

389 S 900
Salt Lake City, UT 84102-2310
Phone (385) 282-2400

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision72
Removal of skin lesions960
Removal or shaving of skin growth13
Skin biopsy562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51102031205UTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Feb 1, 2013 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lanathanh.pho@direct.imail.org

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1013160548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3208",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103208",
            "telephone_number": "801-587-6340",
            "fax_number": "801-587-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841321102",
            "telephone_number": "801-587-6340",
            "fax_number": "801-587-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHO",
        "first_name": "LANA",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "51102031205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lanathanh.pho@direct.imail.org",
            "affiliation": "N",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841321102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THANH LAN",
            "last_name": "PHO",
            "middle_name": "NGOC",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.