Thach Pham, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD20757 Issued in RI

Practice address

2 Dudley St Ste 470
Providence, RI 02905-3248

Phone

(401) 553-8353

Fax

(401) 868-2308

NPI assigned

Mar 10, 2008

Sex

Male

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 RI, MA2 enrollments

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 2

Specialty

General Surgery

Education

Drexel University College of Medicine, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
• Rhode Island Hospital Hospital, Providence, RI, CCN 410007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643

  Surgery

  Medicare reassignment Care Compare group NPD
• University Surgical Associates, Inc.

  • Surgery Physician
  • Providence, RI
  • NPI 1376589895
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group of Massachusetts Inc

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713

  Surgery

  Medicare reassignment Care Compare group NPD (past)
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Rhode Island Hospital

  • Transplant Surgery Physician
  • Providence, RI
  • NPI 1174605208
  NPD
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  NPD (past)

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

• Rhode Island Hospital

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation
• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165
  Care Compare affiliation

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1518137223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "LANDSTUHL REGIONAL MEDICAL CENTER",
            "address_2": "UNIT 33100",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "telephone_number": "314-590-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 470",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-553-8353",
            "fax_number": "401-868-2308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Landstuhl Regional Medical Center",
            "address_2": "Unit 33100",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "country_code": "US",
            "telephone_number": "314-590-5096",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THACH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "16605",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C145443",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "MD20757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lee Pezzone
• David Anthony Pezzullo, DMD
• Mark Daniel Pfeiffer, LICSW
• Scott James Pfirrman, MD
• Catherine Phalen
• Loc Huu Phan, PHARM.D
• Fanta Phannavong
• Amy Phelps, RPH
• Owen Charles Phelps
• Tara Phelps, CRNA

• Surgery Physician in Providence, RI
• Providers in Providence, RI by specialty
• Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.