Individual provider Active NPI

Phung Lieu Levin, DO

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1124370788
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C2-0013087 Issued in DE
Practice address
920 Newington Ave
Baltimore, MD 21217-4631
Phone
(703) 789-7753
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C2-0013087 DE Primary
Family Medicine Physician 207Q00000X 34.012395 OH

Addresses

Primary practice location

920 Newington Ave
Baltimore, MD 21217-4631

Mailing address

920 Newington Ave
Baltimore, MD 21217-4631
Phone (703) 789-7753

Other identifiers 1

IdentifierTypeStateIssuer
0177676MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20190506001837 DE Practitioner - Emergency Medicine 9830483833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Emergency Physicians LLCGroup PAC ID 7719240696, 80 clinicians

Practice addresses (Care Compare)

640 S State St
Bayhealth Emergency Physicians KGH
Dover, DE 19901-3530
Phone (302) 744-6156

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as group
Quality
78.42
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
91.08
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Emergency Physicians LLC Emergency Medicine CurrentSince Aug 9, 2023 Accepting new patients
Emergency Service Associates PA Emergency Medicine CurrentSince Jul 7, 2022 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1124370788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 NEWINGTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174631",
            "telephone_number": "703-789-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 NEWINGTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174631",
            "telephone_number": "703-789-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "PHUNG",
        "middle_name": "LIEU",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C2-0013087",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.012395",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177676",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.