Individual provider Active NPI

Kathleen Pham, MD

  • Vascular & Interventional Radiology Physician
  • Orange, CA
National Provider Identifier
1396249850
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A192501 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-7890
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A192501 CA
Vascular & Interventional Radiology Physician 2085R0204X A192501 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

Other practice location 1

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OH2 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

Enrollment IDStateProvider typePAC IDDetails
I20240919001867 CA Practitioner - Interventional Radiology 6103171822 Reassigns benefits to 2 organizations
I20250619001585 OH Practitioner - Diagnostic Radiology 6103171822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology IncGroup PAC ID 1658274543, 56 clinicians

Practice addresses (Care Compare)

10330 Sawmill Pkwy
Suite 500
Powell, OH 43065-7795
Phone (614) 234-0522

210 N Main St
London, OH 43140-1115
Phone (614) 237-9605

500 S Cleveland Ave
Westerville, OH 43081-8971
Phone (614) 898-8378

5300 N Meadows Dr
Grove City, OH 43123-2546
Phone (614) 663-5301

625 Africa Rd
Suite 140
Westerville, OH 43082-9808
Phone (614) 776-5750

7333 Smiths Mill Rd
New Albany, OH 43054-9291
Phone (614) 775-6600

7911 Diley Rd
Canal Winchester, OH 43110-9653
Phone (614) 838-7911

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192501CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Radiology Medical Group Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Radiology Inc Diagnostic Radiology CurrentSince May 15, 2025 Accepting new patients
UC Regents Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
UC Regents Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients

Locations

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Dept L647
Columbus, OH 43260

10330 Sawmill Pkwy
Ste 500
Powell, OH 43065
Phone (614) 234-0522

Interoperability endpoints

  • Direct secure messaging: kpham4469679@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1396249850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 E Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902622609",
            "country_code": "US",
            "telephone_number": "310-900-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A192501",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A192501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.