Peter T Pham OD, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002204 Issued in VA

Legal business name

PETER T PHAM OD, PLLC

Doing business as

Dr. Peter T Pham & Associates

Practice address

14044 Promenade Commons Street
Gainesville, VA 20155-4072

Phone

(571) 248-6246

Fax

(571) 248-6248

NPI assigned

Oct 10, 2016

Organization subpart

No

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

Authorized official

Name

Peter Pham, O.D.NPI 1003155946

Title

Optometrist

Phone

(571) 248-6246

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Peter T Pham & Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Tien Dzung Pham, O.D.

  • Optometrist
  • Gainesville, VA
  • NPI 1003155946
  Medicare reassignment NPD Authorized official
• Lisa Huynh, OD

  • Optometrist
  • Manassas, VA
  • NPI 1831811108
  Medicare reassignment NPD

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1457801854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 SUDLEY RD",
            "address_2": "STE I-6",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093458",
            "telephone_number": "703-257-7580",
            "fax_number": "703-257-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 PROMENADE COMMONS STREET",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554072",
            "telephone_number": "571-248-6246",
            "fax_number": "571-248-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER T PHAM OD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "571-248-6246",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003155946",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Peter T Pham & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larissa Peralta, LPC
• Performance Care Corporation
• Perioworks LLC
• Shabaan Pervaiz, DDS
• Zan Pervaiz, DDS
• Peter Tien Dzung Pham, O.D.
• VI Phan
• Pharmasutra PLLC (Gainesville Pharmacy)
• David Randell Phelps, APRN
• Phoenix Counselinggroup and Play Therapycenter, PLLC

• Optometrist in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.