Individual provider Active NPI

Luan Pham, MD

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1558526665
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD441569 Issued in PA
Practice address
740 High St
Suite 4001
Williamsport, PA 17701-3100
Phone
(570) 321-2345
Fax
(570) 321-2359
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD441569 PA Primary

Addresses

Primary practice location

740 High St
Suite 4001
Williamsport, PA 17701-3100

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Luan.pham@upmcdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110817000327 PA Practitioner - Family PracticePractitioner - Preventive Medicine 4981873486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

740 High St
Suite 4001
Williamsport, PA 17701-3111
Phone (570) 321-2345

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Susquehanna Physician Services CurrentSince Jan 1, 2014 Accepting new patients
Upmc Williamsport Past Accepting new patients
Susquehanna Physician Services Family Medicine Past Accepting new patients

Locations

740 High St
Ste 1004
Williamsport, PA 17701
Phone (570) 321-3300

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

740 High St
Ste 4001
Williamsport, PA 17701
Phone (570) 321-2345

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1558526665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 HIGH ST",
            "address_2": "SUITE 4001",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-321-2345",
            "fax_number": "570-321-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD441569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Luan.pham@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "UPMC Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "600 Grant St",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.