Individual provider Active NPI

Nam Pham, DO

  • Infectious Disease Physician
  • Renton, WA
National Provider Identifier
1053817205
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
OT018441 Issued in PA
Practice address
4033 Talbot Rd S Ste 570
Renton, WA 98055-5700
Phone
(425) 690-3487
Fax
(425) 690-9087
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT018441 PA
Internal Medicine Physician 207R00000X OS021735 PA
Infectious Disease Physician 207RI0200X OT018441 PA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 570
Renton, WA 98055-5700

Mailing address

4033 Talbot Rd S Ste 570
Renton, WA 98055-5700
Phone (425) 690-3487

Other practice location 1

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone (215) 456-4555

Other practice location 2

2701 Dekalb Pike
East Norriton, PA 19401-1820
Phone (610) 278-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240805000608 WA Practitioner - Infectious Disease 4789935560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Philadelphia College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

4033 Talbot Rd S
Suite 570
Renton, WA 98055-5700
Phone (425) 690-3489

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.34 of 100Reported as apm
Quality
89.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS021735PAMDInternal Medicine Physician
OT018441PAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4033 Talbot Rd S
Ste 570
Renton, WA 98055
Phone (425) 656-5400

3600 Lind Ave SW
Ste 100
Renton, WA 98057

Interoperability endpoints

  • Direct secure messaging: npham122433@direct.valleymed.org

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 3

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1053817205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3487",
            "fax_number": "425-690-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3487",
            "fax_number": "425-690-9087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413098",
            "country_code": "US",
            "telephone_number": "215-456-4555",
            "fax_number": "215-455-1933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 Dekalb Pike",
            "address_purpose": "LOCATION",
            "city": "East Norriton",
            "state": "PA",
            "postal_code": "194011820",
            "country_code": "US",
            "telephone_number": "610-278-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT018441",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS021735",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "OT018441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.