Trevor Phan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12765 Issued in NV

Practice address

801 E Williams Ave
Fallon, NV 89406-3052

Phone

(702) 453-3799

Fax

(702) 453-5741

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

Yes

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.

• Trevor Phan MD PC

  • Hospitalist Physician
  • Fallon, NV
  • NPI 1033418892
  Medicare reassignment Authorized official CA · CO · NV · WA
• Usacs Integrated Acute Care Services of Nevada Bagnoli P C

  • Hospitalist Physician
  • Carson City, NV
  • NPI 1063608701
  NPD (past)
• Delta County Memorial Hospital

  • Rural Acute Care Hospital
  • Delta, CO
  • NPI 1417935446
  NPD (past)
• Lourdes Hospital LLC

  • Rehabilitation Hospital Unit
  • Pasco, WA
  • NPI 1497817654
  NPD (past)
• Lourdes Hospital LLC

  • Critical Access Hospital
  • Pasco, WA
  • NPI 1831284280
  NPD (past)

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

• Banner Churchill Community Hospital

  • Critical Access Hospital
  • Fallon, NV
  • NPI 1265811251
  Care Compare affiliation Hospital
• Delta County Memorial Hospital

  • Rural Acute Care Hospital
  • Delta, CO
  • NPI 1417935446
  Care Compare affiliation Hospital
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation Hospital
• Lourdes Hospital LLC

  • Rehabilitation Hospital Unit
  • Pasco, WA
  • NPI 1497817654
  Care Compare affiliation Inpatient rehabilitation facility
• Lourdes Hospital LLC

  • Critical Access Hospital
  • Pasco, WA
  • NPI 1831284280
  Care Compare affiliation Hospital
• RCCH Trios Health LLC

  • General Acute Care Hospital
  • Kennewick, WA
  • NPI 1578058137
  Care Compare affiliation Hospital

Specialty

Internal Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lourdes Medical Center Hospital, Pasco, WA, CCN 501337
• Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Trios Health Hospital, Kennewick, WA, CCN 500053
• Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313
• Lourdes Medical Center Inpatient rehabilitation facility, Pasco, WA, CCN 50R337
• Delta County Memorial Hospital Nursing home, CCN 06U071

Medicare fee-for-service enrollment

Enrolled in NV, CA, WA, CO4 enrollments

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 22, 2016.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1104943356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17976",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111034",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WILLIAMS AVE",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894063052",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "12765",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "111505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber M. Pagano, PHARMD
• Barbara Ann Patterson
• Kathleen Ann Patterson, FNP-C
• Laura Ashley Petersen, MA, BCBA
• Haylee Petrie
• Janet Leigh Phillips, FNP
• Louis Michael Pickett
• Pacita Platon, M.D.
• Shana Samantha Plount
• Christy E Porter

• All providers in Fallon, NV
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.