Jonathan Theodore Pham

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

A176996 Issued in CA

Practice address

11234 Anderson Street, Gme Office Westerly Suite 'C'
Loma Linda, CA 92354-2804

Phone

(909) 558-4074

NPI assigned

May 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Internal Medicine

Education

Loma Linda University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assisted Home Care Home health agency, Mission Hills, CA, CCN 557089
• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
• Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpham2421313@oc.providencedirect.org

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.

• Providence Facey Medical Foundation

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment Care Compare group NPD
• Providence Facey Medical Foundation

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Henry Mayo Newhall Memorial Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  NPD (past)
• Providence Health System - Southern California

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  NPD (past)

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

• Assisted Home Recovery, Inc.

  • Home Health Agency
  • Mission Hills, CA
  • NPI 1033156765
  Care Compare affiliation
• Assisted Home Recovery, Inc.

  • Home Health Agency
  • Thousand Oaks, CA
  • NPI 1831141845
  Care Compare affiliation
• Henry Mayo Newhall Memorial Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  Care Compare affiliation
• Providence Health System - Southern California

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  Care Compare affiliation

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1548825284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C'",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C'",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JONATHAN",
        "middle_name": "THEODORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-08",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A176996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOMA LINDA UNIVERSITY RISK MANAGEMENT",
            "identifier": "LL2502322",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Pham
• CHI Vu Thao Pham, DO
• Huynh Pham, MD
• John Pham, D.P.M.
• Jonathan Pham, MD
• Katrina Pham, PHARM.D.
• Linda Pham, R. PH.
• Lisa Tran Hoang My Pham, PHARMD
• Minh Nhat Pham, MD
• Nguyen Vo Bao Pham, MD

• Hospitalist Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.