Jacqueline Pham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011232 Issued in CA

Practice address

25272 Marguerite Pkwy
Mission Viejo, CA 92692-2901

Phone

(949) 581-9120

NPI assigned

Sep 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75.98 of 100Reported as group

Quality

66.36

Improvement activities

40

Cost

81.59

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Ocean Psychiatry Inc

  • Psychiatry Physician
  • Fremont, CA
  • NPI 1396306338
  Medicare reassignment NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1114534542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LUCERO W",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201921",
            "telephone_number": "626-991-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25272 MARGUERITE PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926922901",
            "telephone_number": "949-581-9120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20271 SW Birch St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926601714",
            "country_code": "US",
            "telephone_number": "949-553-0260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2021-06-04",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Dao Pham, PHARM D
• Cindy Pham
• Dalena Dang Pham
• Duc Quy Pham, MD
• Hesper Pham, O.D.
• Quyen Van Le Pham, PHARM.D
• Sarah Pham, DDS
• Taryn Lee Phanthanusorn, IBCLC
• Pharmedquest Pharmacy Services
• Jaya Philipose, M.D.

• Family Nurse Practitioner in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.