Bao Tien Pham, D.O

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

OS7296 Issued in FL

Practice address

6816 Southpoint Pkwy
Suite 302
Jacksonville, FL 32216-1700

Phone

(904) 527-3135

Fax

(904) 683-4293

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Pain ManagementAlso: Physical Medicine and Rehabilitation

Education

Philadelphia College of Osteopathic Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Accmed Healthcare Systems Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1215118062
  Medicare reassignment NPD Authorized official
• HCR Manorcare Medical Services of Florida LLC

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1467445403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5377 COMMISSIONERS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240830",
            "telephone_number": "904-527-3135",
            "fax_number": "904-683-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6816 SOUTHPOINT PKWY",
            "address_2": "SUITE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161700",
            "telephone_number": "904-527-3135",
            "fax_number": "904-683-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "BAO",
        "middle_name": "TIEN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS7296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Erin Pfieffer, PCNS-BC, APRN
• Nathan Charvon Phai, DPT
• Phaith Coaching & Counseling, LLC
• Joslyn Phalen, DPT
• Bao Quoc Pham, APRN
• Dat Cao Pham, MD
• Jenny Pham
• John-Paul Pham, MD
• Melissa Pham
• Nhi Pham

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.

Verify at the official NPI Registry.