Kevin HT Phan, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301501266 Issued in MI

Practice address

8805 Haven Ave Ste 200
Rancho Cucamonga, CA 91730-5157

Phone

(909) 912-1750

Fax

(909) 989-4477

NPI assigned

Apr 17, 2014

Sex

Male

Sole proprietor

No

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

Orthopedic Surgery

Education

University of California, San Diego School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Bernardino Medical Orthopaedic Group IncGroup PAC ID 9335045228, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245
• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1336187475
  Medicare reassignment Care Compare group NPD
• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Beaumont, CA
  • NPI 1235964537
  NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)
• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1225239304
  NPD (past)
• Temecula Valley Hospital Inc

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  NPD (past)
• Metropolitan Hospital

  • Registered Dietitian
  • Wyoming, MI
  • NPI 1720028426
  NPD (past)

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

• County of San Bernardino

  • General Acute Care Hospital
  • Colton, CA
  • NPI 1720158009
  Care Compare affiliation
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622937600000",
    "number": "1033539150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744587",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 HAVEN AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305157",
            "telephone_number": "909-912-1750",
            "fax_number": "909-989-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Leffingwell Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495256406",
            "country_code": "US",
            "telephone_number": "616-459-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KEVIN",
        "middle_name": "HT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-06-06",
        "certification_date": "2021-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301501266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Pham
• Tram Pham
• Tuan A Pham, M.D.
• Annie Phan, PA-C
• Cong Thanh Phan, M.D.
• Michelle C Phan, O.D.
• Pharmacy at the Courts LLC
• Norma Phelps
• Adeola Philip-Aimufia
• Sarah Kasham Philips

• Orthopaedic Surgery Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2021; 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.