Laura T Phan, MD

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

A126463 Issued in CA

Practice address

20398 Blauer Dr
Saratoga, CA 95070-4307

Phone

(408) 502-5000

Fax

(408) 502-5505

NPI assigned

Jun 29, 2007

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Virginia Commonwealth University, School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FDJGBA

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.

• Laura Phan, MD, Inc

  • Ophthalmologic Surgery Clinic/Center
  • Saratoga, CA
  • NPI 1174957765
  Medicare reassignment Authorized official
• Thaila Ramanujam M D Inc

  • Specialist
  • Santa Cruz, CA
  • NPI 1700056280
  NPD (past)
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD (past)
• Henry Ford Semi Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Novi, MI
  • NPI 1114133485
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1538366984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20398 BLAUER DR",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704307",
            "telephone_number": "408-502-5000",
            "fax_number": "408-502-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20398 BLAUER DR",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704307",
            "telephone_number": "408-502-5000",
            "fax_number": "408-502-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LAURA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A126463",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D72821",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301097337",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A126463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047445200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ajay Pala
• Lynnea Palazzolo
• Jenny T Pan, MFT TRAINEE
• Jennifer Patane, M.A.
• Sepideh Pejham, D.D.S.
• Melissa Renee Pifer
• Beverly Platzker, PT
• Curtis Lloyd Pontynen, D.D.S.
• Sahana Prasad, D.D.S
• Progressive Subacutecare Saratoga

• Ophthalmic Plastic and Reconstructive Surgery Physician in Saratoga, CA
• Providers in Saratoga, CA by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.