Individual provider Active NPI

Alisa Pham, DO

  • Family Medicine Physician
  • Victoria, TX
National Provider Identifier
1619555190
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V7275 Issued in TX
Practice address
102 Springwood Dr
Victoria, TX 77904-3501
Phone
(361) 579-2222
Fax
(361) 575-5800
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X V7275 TX Primary

Addresses

Primary practice location

102 Springwood Dr
Victoria, TX 77904-3501

Mailing address

102 Springwood Dr
Victoria, TX 77904-3501
Phone (361) 579-2222

Other practice location 1

501 S Washington Ave
Scranton, PA 18505-3814
Phone (570) 343-2383

Other practice location 2

2500 Foundation Way
Martinsburg, WV 25401-9000
Phone (304) 264-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241220000524 WV Practitioner - Family Practice 7810383155 Reassigns benefits to 1 organization
I20250721002349 TX Practitioner - Family Practice 7810383155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Regional Health Center LLPGroup PAC ID 3870493083, 6 clinicians

Practice addresses (Care Compare)

102 Springwood Dr
Victoria, TX 77904-3501
Phone (361) 576-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Single Specialty CurrentSince Dec 4, 2024 Accepting new patients
American Regional Health Center LLP Single Specialty CurrentSince Sep 1, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Dec 4, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

102 Springwood Dr
Victoria, TX 77904
Phone (361) 576-2222

912 Somerset Blvd
Ste 102
Charles Town, WV 25414
Phone (304) 725-2273

171 Taylor St
Harpers Ferry, WV 25425
Phone (304) 535-6343

2500 Foundation Way
Martinsburg, WV 25401
Phone (304) 264-9202

61 Campus Dr
Ste 106
Martinsburg, WV 25404
Phone (304) 274-2273

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

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

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 2

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1619555190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SPRINGWOOD DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043501",
            "telephone_number": "361-579-2222",
            "fax_number": "361-575-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SPRINGWOOD DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043501",
            "telephone_number": "361-579-2222",
            "fax_number": "361-575-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185053814",
            "country_code": "US",
            "telephone_number": "570-343-2383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Foundation Way",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254019000",
            "country_code": "US",
            "telephone_number": "304-264-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ALISA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V7275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.