Individual provider Active NPI

Teresia T Pham, MD

  • Pediatrics Physician
  • Medford, MA
National Provider Identifier
1144677279
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1013820 Issued in MA
Practice address
26 City Hall Mall
Medford, MA 02155-4754
Phone
(781) 306-5100
NPI assigned
May 18, 2016
Last updated
May 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1013820 MA Primary

Addresses

Primary practice location

26 City Hall Mall
Medford, MA 02155-4754

Mailing address

26 City Hall Mall
Medford, MA 02155-4754
Phone (781) 306-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MA2 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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190724003554 TX Practitioner - Pediatric Medicine 8921392572 Reassigns benefits to 1 organization
I20230714001631 MA Practitioner - Pediatric Medicine 8921392572

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Aug 1, 2023 Accepting new patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

26 City Hall Mall
Medford, MA 02155
Phone (781) 306-5100

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

6630 Quaker Ave
Lubbock, TX 79413
Phone (800) 872-2956

Interoperability endpoints

  • Direct secure messaging: teresia.pham@daffodilpeds.gadirect.net
  • Direct secure messaging: tphammd372265@direct.atrius.masshiway.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1144677279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TERESIA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1013820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.