NPIMap

Individual provider Active NPI

Ngo C. Phan, M.D.

  • Family Medicine Physician
  • Alhambra, CA
National Provider Identifier
1043269145
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A64044 Issued in CA
Practice address
2835 W Valley Blvd.
Alhambra, CA 91803
Phone
(626) 281-3265
Fax
(626) 281-3267
NPI assigned
May 8, 2006
Last updated
Sep 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A64044 CA Primary

Addresses

Primary practice location

2835 W Valley Blvd.
Alhambra, CA 91803

Mailing address

2835 W Valley Blvd.
Alhambra, CA 91803
Phone (626) 281-3265

Other identifiers 1

IdentifierTypeStateIssuer
00A640440MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824001462 CA Practitioner - Family Practice 4486628435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ngo Phan MD IncGroup PAC ID 0042460065, 4 clinicians

Practice addresses (Care Compare)

2835 W Valley Blvd
Alhambra, CA 91803-1818
Phone (626) 281-3265

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A64044CAMDFamily Medicine Physician
64044CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ngo Phan MD Inc CurrentSince May 29, 2012 Accepting new patients
Unicare Laboratory, Inc. PastSince Aug 27, 2012 Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients

Locations

2835 W Valley Blvd
Alhambra, CA 91803
Phone (626) 281-3265

330 S Garfield Ave
Ste 268
Alhambra, CA 91801
Phone (626) 281-3265

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/monrovi-3e85a040

Organizations & group practices 5

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 11

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1043269145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 W VALLEY BLVD.",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "91803",
            "telephone_number": "626-281-3265",
            "fax_number": "626-281-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 W VALLEY BLVD.",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "91803",
            "telephone_number": "626-281-3265",
            "fax_number": "626-281-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "NGO",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A640440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.