NPIMap

Individual provider Active NPI

Dennis Namphong Phan, MD

  • Nephrology Physician
  • Salinas, CA
National Provider Identifier
1437238342
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A767040 Issued in CA
Practice address
917 Blanco Circle
Salinas, CA 93901-4446
Phone
(831) 755-7999
Fax
(831) 755-7975
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A767040 CA Primary

Addresses

Primary practice location

917 Blanco Circle
Salinas, CA 93901-4446

Mailing address

917 Blanco Circle
Salinas, CA 93901-4446
Phone (831) 755-7999

Other identifiers 1

IdentifierTypeStateIssuer
00A767040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000978 CA Practitioner - Nephrology 2668416314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hazel Hawkins Memorial HospitalGroup PAC ID 9133038326, 52 clinicians

Practice addresses (Care Compare)

911 Sunset Dr
Hollister, CA 95023-5606
Phone 83163726262601

917 Blanco Cir
Salinas, CA 93901-4446
Phone (831) 755-7999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A767040CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hazel Hawkins Memorial Hospital CurrentSince Oct 1, 2015 Accepting new patients
Central Coast Nephrology Medical Corporation Nephrology CurrentSince Jul 1, 2005 Accepting new patients
Hazel Hawkins Memorial Hospital CurrentSince Oct 1, 2015 Accepting new patients
Salinas Valley Memorial Healthcare System Past Accepting new patients
County of Santa Clara Past Accepting new patients
County of Monterey Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients

Locations

9400 No Name Uno
Gilroy, CA 95020
Phone (408) 848-2000

8095 Camino Arroyo
#200
Gilroy, CA 95020
Phone (408) 847-2200

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

917 Blanco Cir
Salinas, CA 93901
Phone (831) 755-7999

450 E Romie Ln
Salinas, CA 93901
Phone (831) 372-7844

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dphan126204@santaclaravalley.direct-ci.net
  • Direct secure messaging: dennis.phan@hhch.eclinicaldirectplus.com
  • Direct secure messaging: dphan17725@direct.svmh.com

Organizations & group practices 7

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 8

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437238342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 BLANCO CIRCLE",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014446",
            "telephone_number": "831-755-7999",
            "fax_number": "831-755-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BLANCO CIRCLE",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014446",
            "telephone_number": "831-755-7999",
            "fax_number": "831-755-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DENNIS",
        "middle_name": "NAMPHONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A767040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A767040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.