Individual provider Active NPI

Thy Pham, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1063868420
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10426 Issued in TX
Practice address
221 W. Colorado Blvd
Pavilion II Suite 933
Dallas, TX 75208-6800
Phone
(214) 947-3684
Fax
(214) 947-3686
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10426 TX Primary

Addresses

Primary practice location

221 W. Colorado Blvd
Pavilion II Suite 933
Dallas, TX 75208-6800

Mailing address

221 W. Colorado Blvd
Pavilion II Suite 933
Dallas, TX 75208-6800
Phone (214) 947-3684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512000552 TX Practitioner - Physician Assistant 5799074860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 833-3478

3000 Blackburn St
Suite 130
Dallas, TX 75204-2217
Phone (214) 599-8624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Jun 7, 2021 Accepting new patients
Medhealth Past Accepting new patients

Locations

221 W Colorado Blvd
Ste 431
Dallas, TX 75208
Phone (214) 943-1171

221 W Colorado Blvd
Ste 933
Dallas, TX 75208
Phone (214) 941-7200

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

Interoperability endpoints

  • Direct secure messaging: tpham152760@dm.mhd.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1063868420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W. COLORADO BLVD",
            "address_2": "PAVILION II SUITE 933",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086800",
            "telephone_number": "214-947-3684",
            "fax_number": "214-947-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W. COLORADO BLVD",
            "address_2": "PAVILION II SUITE 933",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086800",
            "telephone_number": "214-947-3684",
            "fax_number": "214-947-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2025-05-02",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.