Individual provider Active NPI

Hung Tan Pham

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1033650023
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS019654 Issued in PA
Practice address
101 E Olney Ave Ste C5
Philadelphia, PA 19120-2470
Phone
(215) 927-1937
Fax
(215) 456-6240
NPI assigned
Mar 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS019654 PA Primary

Addresses

Primary practice location

101 E Olney Ave Ste C5
Philadelphia, PA 19120-2470

Mailing address

101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-1825

Other practice location 1

4190 City Ave
Philadelphia, PA 19131-1626
Phone (215) 871-6690

Other identifiers 1

IdentifierTypeStateIssuer
103803880MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200812001310 PA Practitioner - Internal Medicine 3971875741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 E Olney Ave
Suite C5
Philadelphia, PA 19120-2470
Phone (215) 927-1937

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc CurrentSince May 8, 2020 Accepting new patients
Einstein Community Health Associates, Inc Internal Medicine CurrentSince May 8, 2020 Accepting new patients

Locations

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1033650023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-456-1825",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE C5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-927-1937",
            "fax_number": "215-456-6240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311626",
            "country_code": "US",
            "telephone_number": "215-871-6690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HUNG",
        "middle_name": "TAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103803880",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.