Annette M Pham, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

D68124 Issued in MD

Practice address

3204 Tower Oaks Blvd Ste 400
Rockville, MD 20852-4250

Phone

(301) 315-0003

Fax

(301) 315-0002

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

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

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Rutgers New Jersey Medical School, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centers for Advanced ENT Care LLCGroup PAC ID 1658647359, 103 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Centers for Advanced ENT Care, LLC

  • Otolaryngology Physician
  • Baltimore, MD
  • NPI 1447781620

  DC

  Medicare reassignment Care Compare group NPD
• Rockville Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Rockville, MD
  • NPI 1336635747
  NPD
• Cumberland Valley ENT Consultants

  dba Drs. Drawbaugh, Saylor, Wathne & Cukier, P. A.

  • Otolaryngology Physician
  • Hagerstown, MD
  • NPI 1649272824
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591401600000",
    "number": "1013991884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 TOWER OAKS BLVD STE 400",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524250",
            "telephone_number": "301-315-0003",
            "fax_number": "301-315-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 TOWER OAKS BLVD STE 400",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524250",
            "telephone_number": "301-315-0003",
            "fax_number": "301-315-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-06-06",
        "certification_date": "2020-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME98443",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D68124",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A87280",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D68124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020467600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1013991884",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myria Petrou, MBCHB
• Teara Pettiford
• Kelly Pettigen
• Tiera Petway
• Charlene Makomborero Pfinayi, PA-C
• Hiep Huy Pham
• Thao Pham
• Jade Phan
• Lysa Phan, L. AC.
• Que CHI Phan

• Otolaryngology Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Otolaryngology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2020; 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.