Individual provider Active NPI

Uyen Kim Pham, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1477098382
Registry record updated Dec 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone
(405) 755-1515
NPI assigned
Dec 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4300 W Memorial Rd
Oklahoma City, OK 73120-8304

Mailing address

1401 N Ellison Ave
Oklahoma City, OK 73106-4436
Phone (405) 213-6875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170227000326 OK Practitioner - Physician Assistant 7416231071 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

5200 E I 240 Service Rd
Suite 330
Oklahoma City, OK 73135-2607
Phone (405) 755-4290

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2735OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County, Inc CurrentSince Oct 1, 2019 Accepting new patients
True North Health Navigation LLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

2525 NW Expressway St
Ste 102
Oklahoma City, OK 73112
Phone (405) 213-0190

Interoperability endpoints

  • Direct secure messaging: upham496204@direct.integrisok.com

Organizations & group practices 5

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 1

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": "1483142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483142400000",
    "number": "1477098382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N ELLISON AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731064436",
            "telephone_number": "405-213-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208304",
            "telephone_number": "405-755-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "UYEN",
        "middle_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-31",
        "last_updated": "2016-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.