NPIMap

Individual provider Active NPI

Kevin Pham, M.D.

  • Nephrology Physician
  • Orange, CA
National Provider Identifier
1477623635
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A67209 Issued in CA
Practice address
500 S Main St
Suite 101
Orange, CA 92868-4507
Phone
(714) 836-4204
Fax
(714) 836-1809
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A67209 CA Primary

Addresses

Primary practice location

500 S Main St
Suite 101
Orange, CA 92868-4507

Mailing address

500 S Main St
Suite 101
Orange, CA 92868-4507
Phone (714) 836-4204

Other identifiers 2

IdentifierTypeStateIssuer
00A672090OtherCALOPTIMA
00A672090OtherBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040701000742 CA Practitioner - NephrologyPractitioner - Internal Medicine 3476530056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of California, San Diego School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerhealth Medical Group IncGroup PAC ID 8820522006, 9 clinicians
Kevin Pham MD IncGroup PAC ID 3375523277, 5 clinicians

Practice addresses (Care Compare)

2077 Harbor Blvd
Suite 100
Costa Mesa, CA 92627-9384
Phone (949) 740-7117

500 S Main St
Suite 101
Orange, CA 92868-4535
Phone (714) 836-4204

Hospital & facility affiliations

  • SHC Orange Dialysis facility, Orange, CA, CCN 552609
  • SHC Katella Dialysis facility, Orange, CA, CCN 752530
  • SHC Santa Ana Dialysis facility, Santa Ana, CA, CCN 752500
  • Rai - New Hope - Fountain Valley Dialysis facility, Fountain Valley, CA, CCN 052798
  • St Joseph Hospital Renal Center Dialysis facility, Orange, CA, CCN 052368
  • Alta Home Health Care Services, Inc. Home health agency, Garden Grove, CA, CCN 757271
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerhealth Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Satellite Healthcare of Katella Avenue, LLC PastSince Apr 1, 2020 Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Michael M Dao MD Inc Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Santa Ana Clinica Medica General Medical Center Inc. PastSince Apr 28, 2003 Accepting new patients
St. Joseph Satellite Dialysis Centers, LLC PastSince Apr 1, 2017 Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
St. Joseph Hospital Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

2077 Harbor Blvd
Ste 100
Costa Mesa, CA 92627
Phone (949) 740-7117

2077 Harbor Blvd
Ste A
Costa Mesa, CA 92627
Phone (949) 414-2934

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kevinpham@kpm-ca.direct.office.nextgen.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 10

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1477623635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684507",
            "telephone_number": "714-836-4204",
            "fax_number": "714-836-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684507",
            "telephone_number": "714-836-4204",
            "fax_number": "714-836-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A67209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00A672090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A672090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.