An T Phan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

82073 Issued in MA

Practice address

1370 Dorchester Ave
Ste 23
Dorchester, MA 02122-2921

Phone

(617) 288-8883

Fax

(617) 288-8887

NPI assigned

Aug 8, 2006

Last updated

Nov 30, 2016By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1588674030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 DORCHESTER AVE",
            "address_2": "STE 23",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021222921",
            "telephone_number": "617-288-8883",
            "fax_number": "617-288-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 DORCHESTER AVE",
            "address_2": "STE 23",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021222921",
            "telephone_number": "617-288-8883",
            "fax_number": "617-288-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "AN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "82073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110057033A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Pham-DO
• Chen Pham, RPH
• Mymie Pham
• Nga Pham, PHARM.D.
• Tanya Pham
• Lan-Thuy Phan
• Nuong Ai Phan, LIC.AC.
• Edna Phifer, RN, BSN
• Susan K Phillip, NDTR
• Sarah Christiane Phillips, MD

• Family Medicine Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.