Ethan Pham

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1030 E Guadalupe Rd
Tempe, AZ 85283-3044

Phone

(480) 491-1898

NPI assigned

Jul 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Transitions Center PLLCGroup PAC ID 6507132016, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: transitionscenter.ethanpham@149834.advancedmd-direct.com

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.

• Transitions Center PLLC

  • Psychiatry Physician
  • Tempe, AZ
  • NPI 1821485954
  Medicare reassignment Care Compare group
• Psychiatric Associates, PLLC

  • Child & Adolescent Psychiatry Physician
  • Tempe, AZ
  • NPI 1699681718
  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1144954488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 N 7TH ST UNIT 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061067",
            "telephone_number": "714-908-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E GUADALUPE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833044",
            "telephone_number": "480-491-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ETHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Peuse, DC
• Crista Pfeiffer
• Sharon Kaye Pfeiffer, PNP
• Daryl R Pfister, M.D.
• Duy Trong Pham
• Kimberly Pham, PHARMD
• Thu Thuy Thi Pham, RDH
• Tracey Diep Pham, PHARMD
• Ashley Marie Phelps, R.N.
• Derek Michael Phelps, OD

• Physician Assistant in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.