Active NPI
Oanh Hoang Nguyen Phan, NP-C
- Family Nurse Practitioner
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95012565
- Practice address
- 4601 Dale Rd
Modesto, CA 95356-9718 - Phone
- (209) 735-6810
- NPI assigned
- Sep 3, 2019
- Last updated
- Jan 3, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95012565 | CA | Primary |
Addresses
Primary practice location
4601 Dale Rd
Modesto, CA 95356-9718
Mailing address
1674 Scott Blvd
Santa Clara, CA 95050-4108
Phone (408) 857-4969
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of California, Davis School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1390 Market St
Suite 109
San Francisco, CA 94102-5403
Phone (415) 918-5766
1998 Market St
San Francisco, CA 94102-6228
Phone (415) 792-6040
3251 20TH Ave
Suite 320
San Francisco, CA 94132-1915
Phone (415) 480-1160
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95012565 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| County of Santa Clara | Current | Accepting new patients | |
| Hill Physicians Medical Group - PPO Program | Past | Accepting new patients |
Locations
7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400
1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320
751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110
2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050
750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320
500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433
1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846
660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366
Interoperability endpoints
- ophan179226@santaclaravalley.direct-ci.net
Organizations & group practices 8
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.
-
dba Carbon Health
- Urgent Care Clinic/Center
- Berkeley, CA
- NPI 1417294232
-
dba SCVMC Physician Services
- Anesthesiology Physician
- San Jose, CA
- NPI 1588721500
-
dba Valley Health Center Alexian
- Federally Qualified Health Center (FQHC)
- San Jose, CA
- NPI 1629301346
-
dba Josefina Narvaez Mental Health Center MH Aoa
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Jose, CA
- NPI 1699885079
-
dba Valley Health Center Lundy
- Federally Qualified Health Center (FQHC)
- San Jose, CA
- NPI 1043354020
-
- Preferred Provider Organization
- San Ramon, CA
- NPI 1679011035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1467000463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1674 SCOTT BLVD",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950504108",
"telephone_number": "408-857-4969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 DALE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569718",
"telephone_number": "209-735-6810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "OANH",
"middle_name": "HOANG NGUYEN",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95012565",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1200 El Camino Real",
"city": "South San Francisco",
"state": "CA",
"country_code": "US",
"postal_code": "940803208",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.