Vincent Dong Phan

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

ME122707 Issued in FL

Practice address

1350 Hickory St
Melbourne, FL 32901-3224

Phone

(321) 434-1771

Fax

(321) 434-1775

NPI assigned

May 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

HospitalistAlso: Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Medicine Services, LLCGroup PAC ID 7810129640, 263 clinicians

Eastside Hospitalists IncGroup PAC ID 9436157831, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health North Hospital, Deerfield Beach, FL, CCN 100086

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eastside Hospitalists Inc

  • Hospitalist Physician
  • Hollywood, FL
  • NPI 1285676957
  Medicare reassignment Care Compare group NPD
• Florida Hospital Medicine Services, LLC.

  • Hospitalist Physician
  • Boca Raton, FL
  • NPI 1508873183
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• North Broward Hospitalist Inc

  • Hospitalist Physician
  • Fort Lauderdale, FL
  • NPI 1114193034

  Internal Medicine

  Medicare reassignment NPD
• West Palm Beach Physician Group Inc

  • Hospitalist Physician
  • Boca Raton, FL
  • NPI 1235231465
  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164

  Internal Medicine

  NPD
• Inpatient Consultants of Florida, Inc

  • Hospitalist Physician
  • Clearwater, FL
  • NPI 1811179831

  Internal Medicine

  NPD

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

• North Broward Hospital District

  • General Acute Care Hospital
  • Pompano Beach, FL
  • NPI 1376571323
  Care Compare affiliation
• North Broward Hospital District

  • Emergency Care Clinic/Center
  • Lighthouse Point, FL
  • NPI 1720936792

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1083973150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-1771",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-1771",
            "fax_number": "321-434-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "VINCENT",
        "middle_name": "DONG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME122707",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME122707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL RR MEDICARE",
            "identifier": "P02395742",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IH482W",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015599300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jagger Petriello
• Cheyenne Nani Petty
• Brenna Koretsky Pezo, M.A.
• PFRC
• Katherine Pham
• Christopher Lee Pheils, PA-C
• Lyudmila Philips, MD
• Denise Philistin, RT
• Phillip W Devoe MD PA
• Deena Phillips

• Hospitalist Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.