Individual provider Active NPI

Tung Pham

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1255171807
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2757 S Seneca St Ste B
Wichita, KS 67217-2862
Phone
(316) 260-3311
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X KS Primary

Addresses

Primary practice location

2757 S Seneca St Ste B
Wichita, KS 67217-2862

Mailing address

2757 S Seneca St Ste B
Wichita, KS 67217-2862
Phone (316) 260-3311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628003761 KS Practitioner - Physical Therapist in Private Practice 0143764209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Physical Therapy LLCGroup PAC ID 3779914544, 50 clinicians

Practice addresses (Care Compare)

2757 S Seneca St
Suite B
Wichita, KS 67217-2862
Phone (316) 260-3311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Physical Therapy LLC CurrentSince Jun 21, 2024 Accepting new patients

Locations

12627 E Central Ave
Wichita, KS 67206

12627 E Central Ave
Ste 308
Wichita, KS 67206

2757 S Seneca St
Ste B
Wichita, KS 67217
Phone (316) 440-3731

3223 N Webb Rd
Ste 2
Wichita, KS 67226
Phone (316) 609-3040

Organizations & group practices 1

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1255171807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 S SENECA ST STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672172862",
            "telephone_number": "316-260-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 S SENECA ST STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672172862",
            "telephone_number": "316-260-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.