Individual provider Active NPI

Charlie Phung

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1336647874
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
24570611 Issued in TX
Practice address
6431 Fannin St Ste 5020
Houston, TX 77030-1501
Phone
(713) 500-6200
Fax
(713) 500-0648
NPI assigned
Jan 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 24570611 TX Primary

Addresses

Primary practice location

6431 Fannin St Ste 5020
Houston, TX 77030-1501

Mailing address

5214 Cornish St
Houston, TX 77007-1910
Phone (281) 415-8958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827002105 TX Practitioner - Anesthesiology Assistant 4082963970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
24570611TXMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Anesthesia Providers PLLC CurrentSince Jun 10, 2020 Accepting new patients
Ut Physicians CurrentSince Jun 4, 2018 Accepting new patients
Ut Physicians CurrentSince Jun 4, 2018 Accepting new patients

Locations

4201 Garth Rd
Ste 212
Baytown, TX 77521
Phone (281) 420-9355

6431 Fannin St
Ste 5020
Houston, TX 77030
Phone (713) 500-6200

510 W Tidwell Rd
Houston, TX 77091
Phone (281) 618-8500

4200 Twelve Oaks Dr
Houston, TX 77027
Phone (713) 621-5010

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1475 FM 1960 Bypass Rd E
Humble, TX 77338
Phone (281) 369-9001

17510 W Grand Pkwy S
Ste 200
Sugar Land, TX 77479
Phone (281) 238-1600

1211 Highway 6
Ste 70
Sugar Land, TX 77478
Phone (281) 238-3902

17510 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 238-1600

1211 Highway 6
Sugar Land, TX 77478
Phone (281) 238-3900

2225 Williams Trace Blvd
Ste 108
Sugar Land, TX 77478
Phone (281) 240-4300

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

333 N Texas Ave
Webster, TX 77598
Phone (281) 335-1700

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336647874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 CORNISH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770071910",
            "telephone_number": "281-415-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE 5020",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6200",
            "fax_number": "713-500-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "CHARLIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-30",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "24570611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.