Active NPI
Lee Nguyen Phan, D.O.
- Interventional Cardiology Physician
- Brandon, FL
National Provider Identifier
1487005138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- OS19660
- Practice address
- 621 W Lumsden Rd
Brandon, FL 33511-5911 - Phone
- (813) 755-3500
- Fax
- (813) 755-3300
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Interventional Cardiology Physician | 207RI0011X | OS19660 | FL | Primary |
Addresses
Primary practice location
621 W Lumsden Rd
Brandon, FL 33511-5911
Mailing address
621 W Lumsden Rd
Brandon, FL 33511-5911
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230531002057 | FL | Practitioner - Interventional Cardiology | 7416314885 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- William Carey University College of Osteopathic Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Tower Imaging LLCHeart Vascular and Vein of Tampa Bay LLC
Practice addresses (Care Compare)
2 Tampa General Cir
Tampa, FL 33606-3571
Phone 81325327211937
621 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 755-3500
Hospital & facility affiliations
- St Josephs Hospital
- Tampa General Hospital
- HCA Florida Brandon Hospital
- HCA Florida South Shore Hospital
- Adventhealth Tampa
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.22 of 100
- Quality
- 95.56
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.07 of 100
- Quality
- 76.33
- Improvement activities
- 40
- Cost
- 78.47
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 25 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS19660 | FL | MD | Interventional Cardiology Physician |
Practice roles (5 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tower Imaging LLC | Current | Accepting new patients | |
| Tower Imaging LLC | Current | Accepting new patients | |
| Tower Imaging LLC | Current | Accepting new patients | |
| Heart Vascular and Vein of Tampa Bay LLC | Current | Accepting new patients | |
| Sunshine Pulmonary and Sleep Medicine P.a. | Current | Accepting new patients |
Locations
621 W Lumsden Rd
Brandon, FL 33511
Phone (813) 655-1100
10141 Big Bend Rd
Ste 201
Riverview, FL 33578
Phone (813) 684-3707
1901 Haverford Ave
Ste 111
Sun City Ctr, FL 33573
Phone (727) 231-0846
2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191
2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700
2324 Oak Myrtle Ln
Wesley Chapel, FL 33544
Phone (813) 751-0422
11621 Kew Gardens Ave
West Palm Beach, FL 33410
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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.
-
- Cardiovascular Disease Physician
- Brandon, FL
- NPI 1518580307
FL
-
- Pulmonary Disease Physician
- Brandon, FL
- NPI 1780009548
-
- Diagnostic Radiology Physician
- Tampa, FL
- NPI 1396707063
-
- Diagnostic Radiology Physician
- Spring Hill, FL
- NPI 1669267134
Hospital & facility affiliations 7
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": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1487005138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 W LUMSDEN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 W LUMSDEN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115911",
"telephone_number": "813-755-3500",
"fax_number": "813-755-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "LEE",
"middle_name": "NGUYEN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "FL",
"license": "OS19660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.