Jennifer Lee Pham, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

69153 Issued in WI

Practice address

9000 W Wisconsin Ave
Milwaukee, WI 53226

Phone

(414) 266-3360

Fax

(414) 266-3563

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, NV2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Pokroy Medical Group of Nevada, LTD.

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412

  Pediatrics

  Medicare reassignment NPD
• Sunrise Hospital and Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1861439952
  NPD (past)

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1245527043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-3360",
            "fax_number": "414-266-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-266-3360",
            "fax_number": "414-266-3563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 512-12",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "6601",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WI",
            "license": "69153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245527043",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryne Pflieger, DO
• Lauren Elizabeth Pflum, PA-C
• PH Milwaukee, LLC
• Daniel Xuantung Pham
• Hien Dieu Pham, RN
• Keith Pham, M.D.
• Le Pham, PHARMD
• Luu Quang Pham, MD
• Nhan Thien Pham, CAA
• Alexandria T Phan, M.D.

• Pediatric Critical Care Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Critical Care Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.