Individual provider Active NPI

Thien-Kim Phan Le, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1508283789
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77286 Issued in GA
Practice address
740 Ralph McGill Blvd NE
Atlanta, GA 30312-1118
Phone
(404) 251-1740
Fax
(404) 332-3384
NPI assigned
Mar 25, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 77286 GA Primary

Addresses

Primary practice location

740 Ralph McGill Blvd NE
Atlanta, GA 30312-1118

Mailing address

740 Ralph McGill Blvd NE
Atlanta, GA 30312-1118
Phone (404) 251-1740

Other practice location 1

4500 N Shallowford Rd
Dunwoody, GA 30338-6476
Phone (404) 778-6920

Other practice location 2

8108 SW 65th Ln
Gainesville, FL 32608-7503
Phone (813) 601-2212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20170822001605 GA Practitioner - Family Practice 9133422355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77286GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Multi-Specialty CurrentSince Aug 28, 2017 Accepting new patients
Crawford Long Hospital Multi-Specialty Past Accepting new patients
Emory Health Care Multi-Specialty Past Accepting new patients
Emory Specialty Associates, LLC Multi-Specialty PastSince Jul 24, 2022 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: tle45174@direct.emory.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508283789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 RALPH MCGILL BLVD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121118",
            "telephone_number": "404-251-1740",
            "fax_number": "404-332-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 RALPH MCGILL BLVD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121118",
            "telephone_number": "404-251-1740",
            "fax_number": "404-332-3384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 N Shallowford Rd",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303386476",
            "country_code": "US",
            "telephone_number": "404-778-6920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8108 SW 65th Ln",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326087503",
            "country_code": "US",
            "telephone_number": "813-601-2212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "THIEN-KIM",
        "middle_name": "PHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "77286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.