Individual provider Active NPI

Dean Huy Pham

  • Anesthesiologist Assistant
  • Kansas City, MO
National Provider Identifier
1265079586
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2023018543 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
Fax
(816) 302-9939
NPI assigned
Dec 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2023018543 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Provider Enrollment Department
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other identifiers 2

IdentifierTypeStateIssuer
2023018543OtherMOMISSOURI STATE BOARD OF REGISTRATIONS FOR THE HEALING ARTS
75000090AOtherININDIANA PROFESSIONAL LICENSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpham1@direct.iuhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608002825 MO Practitioner - Anesthesiology Assistant 8820410558 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023018543MOMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Mercy Hospital CurrentSince Jun 6, 2023 Accepting new patients
The Children'S Mercy Hospital CurrentSince Jun 6, 2023 Accepting new patients

Locations

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1265079586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DEAN",
        "middle_name": "HUY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-05",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2023018543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF REGISTRATIONS FOR THE HEALING ARTS",
            "identifier": "2023018543",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING",
            "identifier": "75000090A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpham1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "705 Riley Hospital Dr",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.