Phung Ngoc Phan

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP95017548 Issued in CA

Practice address

1596 W Minerva Ave
Anaheim, CA 92802-1624

Phone

(714) 675-5925

NPI assigned

Jan 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advantage Neuropsychiatric Associates a P CGroup PAC ID 0547395048, 16 clinicians

Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Anaheim Medical Center Hospital, Anaheim, CA, CCN 050426

Merit-based Incentive Payment System (MIPS)

Final score

81.67 of 100Reported as group

Quality

74.98

Improvement activities

40

Cost

51.43

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phung.phan.p1@direct.sokya.nextgenshare.com

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.

• Advantage Neuropsychiatric Associates a P C

  • Psychiatry Physician
  • Orange, CA
  • NPI 1043455850
  Medicare reassignment Care Compare group NPD
• Sokyahealth Medical Group PC

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1942970330
  Medicare reassignment Care Compare group NPD
• Headlight Health Medical Group PLLC

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1649064486
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Anaheim, LLC

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1871501916
  Care Compare affiliation

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1487152534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 W MINERVA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1596 W MINERVA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021624",
            "telephone_number": "714-675-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Hughes Way Ste 150",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908101878",
            "country_code": "US",
            "telephone_number": "310-221-6336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHUNG",
        "middle_name": "NGOC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95044332",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95044332",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95017548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diem Huong Thi Phan
• Dylan Phan
• Jacqueline Vannga Phan, D.C., L.AC.
• Minh Phan
• Paul Phan, PHARM D
• Samuel Khoa Phan, ASW
• Vu T Phan, NP
• Xuan Phan
• Pharm Plus Acquisition Inc
• Pharm-One, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.