Individual provider Active NPI

An Pham, M.D.

  • Pediatric Adolescent Medicine Physician
  • Richmond, VA
National Provider Identifier
1356899082
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
0101272792 Issued in VA
Practice address
1000 E Broad St
Richmond, VA 23219-1930
Phone
(804) 628-5880
NPI assigned
Sep 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60764804 WA
Pediatrics Physician 208000000X 144305 CA
Pediatric Adolescent Medicine Physician 2080A0000X 60764804 WA
Pediatric Adolescent Medicine Physician 2080A0000X 0101272792 VA Primary

Addresses

Primary practice location

1000 E Broad St
Richmond, VA 23219-1930

Mailing address

9291 Krepp Dr
Huntington Beach, CA 92646-2705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211019001257 VA Practitioner - Pediatric Medicine 2961834452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
144305CAMDPediatrics Physician
60764804WAMDPediatrics Physician
0101272792VAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Pediatrics CurrentSince Jul 6, 2021 Accepting new patients

Locations

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1000 E Broad St
Richmond, VA 23219

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1356899082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9291 KREPP DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926462705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191930",
            "telephone_number": "804-628-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "AN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-11",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60764804",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "144305",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "60764804",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VA",
            "license": "0101272792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.