Peter Duy Pham, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

T52-2014 Issued in TX

Practice address

17200 NW Corridor CT Ste 108
Beaverton, OR 97006-3295

Phone

(503) 292-9252

NPI assigned

Jun 23, 2014

Last updated

Dec 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Extremity Specialists LLCGroup PAC ID 3577881747, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHGCBD
• Direct secure messaging: peter.pham@pfac.eclinicaldirectplus.com
• Direct secure messaging: ppham154725@direct.ohsu.edu

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.

• Northwest Extremity Specialists LLC

  • Podiatrist
  • Portland, OR
  • NPI 1295126241
  Medicare reassignment Care Compare group NPD
• Northwest Extremity Specialists LLC

  dba NES Wilsonville

  • Podiatric Clinic/Center
  • Wilsonville, OR
  • NPI 1346973039
  NPD
• Elite Foot & Ankle Associates LLC

  • Foot & Ankle Surgery Podiatrist
  • Sandy, OR
  • NPI 1700386992
  NPD (past)

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

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Willamette Falls Medical Center

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1568877264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235838",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT STE 108",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-292-9252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12121 Richmond Ave",
            "address_2": "suite 417",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770822432",
            "country_code": "US",
            "telephone_number": "281-597-1630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 NW Lovejoy St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972105103",
            "country_code": "US",
            "telephone_number": "503-245-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PETER",
        "middle_name": "DUY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "T52-2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bichson Pham, D.O.
• Diane Pham, PHARM.D.
• Huy Pham, PHARM.D
• Jacqueline O Pham
• Nina Pham
• Pierre Quang Pham, MD
• Thomas T Pham, DMD
• Thong Minh Pham, RPH
• Jenny Thuy Phan Yee, RPH
• Albert Phan, D.O.

• Podiatrist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.