NPIMap

Individual provider Active NPI

Angie Khue-VI Pham, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Seattle, WA
National Provider Identifier
1437368388
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A92586 Issued in CA
Practice address
1001 SW Klickitat Way
Suite 205
Seattle, WA 98134-1161
Phone
(206) 622-7747
Fax
(206) 467-1470
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A92586 CA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD60118420 WA
Hematology (Pathology) Physician 207ZH0000X MD60118420 WA

Addresses

Primary practice location

1001 SW Klickitat Way
Suite 205
Seattle, WA 98134-1161

Mailing address

PO Box 34245
Seattle, WA 98124-1245
Phone (206) 622-7747

Other identifiers 3

IdentifierTypeStateIssuer
258441OtherWADEPARTMENT OF LABOR & INDUSTRIES
8563595MedicaidWA
P00873143OtherWARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100518000899 WA Practitioner - PathologyPractitioner - Hematology/Oncology 7214066950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology/Oncology
Education
University of Oklahoma College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cellnetix Pathology PLLCGroup PAC ID 8224062971, 58 clinicians

Practice addresses (Care Compare)

1124 Columbia St
Suite 200
Seattle, WA 98104-2048
Phone (206) 386-2676

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92586CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cellnetix Pathology, PLLC Hematology CurrentSince Apr 1, 2017 Accepting new patients
Cellnetix Pathology, PLLC Hematology Current Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2017 Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1001 SW Klickitat Way
Ste 205
Seattle, WA 98134
Phone (206) 622-7747

1124 Columbia St
Ste 200
Seattle, WA 98104
Phone (206) 576-6050

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1780 NW Myhre Rd
Ste 1240
Silverdale, WA 98383
Phone (360) 337-8915

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

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 9

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1437368388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34245",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241245",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SW KLICKITAT WAY",
            "address_2": "SUITE 205",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341161",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANGIE",
        "middle_name": "KHUE-VI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A92586",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD60118420",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "WA",
            "license": "MD60118420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR & INDUSTRIES",
            "identifier": "258441",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8563595",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00873143",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.