Jennifer Thuy Ho Phung, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A107567 Issued in CA

Practice address

2545 W Hammer LN
Stockton, CA 95209-2839

Phone

(209) 957-7050

NPI assigned

Jul 2, 2008

Sex

Female

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 CA

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

Obstetrics/Gynecology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Procedures performed for Medicare patients

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.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment Care Compare group
• DHP of California Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Stockton, CA
  • NPI 1679836084
  Medicare reassignment NPD
• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  NPD (past)
• Sutter North Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

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

• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1114180999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-957-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "JENNIFER",
        "middle_name": "THUY HO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A107567",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A107567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID",
            "identifier": "68-0277719",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1075670",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1386636165",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Phongsa
• Sarah Vang Phoong
• Megan Phornsavanh
• Sidaphone Anna Phovixay, ASW61745
• Amarpreet K Phul
• Physiosport: Performance and Physical Therapy Inc.
• Torrie Alyn-Hughes Piasecki, LCSW
• Francesca Piazza
• Mirella Elizabeth Piceno
• Yomira Pichardo

• Obstetrics & Gynecology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.