Active NPI
Hongvan Cao Phan, PA
- Physician Assistant
- New York, NY
National Provider Identifier
1174539308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004132
- Practice address
- 10 Union SQ E Ste 2Q2R
New York, NY 10003-3314 - Phone
- (212) 844-1097
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004132 | NY | Primary |
Addresses
Primary practice location
10 Union SQ E Ste 2Q2R
New York, NY 10003-3314
Mailing address
PO Box 95000-2435
Philadelphia, PA 19195-2435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004132 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363305600000",
"number": "1174539308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 95000-2435",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191952435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 UNION SQ E STE 2Q2R",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033314",
"telephone_number": "212-844-1097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "HONGVAN",
"middle_name": "CAO",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2013-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.