Andrew Phan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD16339 Issued in ME

Practice address

331 Veranda St
Portland, ME 04103-5545

Phone

(207) 828-2402

Fax

(207) 828-2425

NPI assigned

Jun 10, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Family PracticeAlso: Sports Medicine

Education

University of Texas Medical School at Houston, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin'S Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4

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.

• Martin'S Point Health Care, Inc.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1366474611
  Medicare reassignment Care Compare group NPD

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

• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1427313048
  Care Compare affiliation
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1629078712
  Care Compare affiliation

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1619918307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888",
            "fax_number": "207-828-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 VERANDA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035545",
            "telephone_number": "207-828-2402",
            "fax_number": "207-828-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD16339",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD16339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417270099",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.phan.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "331 Veranda St",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041035545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roger T Pezzuti, M.D.
• Kristen Pfeifle, M.S
• Nicholas Pfenning, CADC
• Rachel Elise Pferdehirt, M.D.
• Rishi Phakey, DMD
• Pharmerica East LLC
• Brianna Marie Philbrick, MD
• Leighton R Philbrick, D.M.D.
• Robert Philbrook, LCPC
• Christine Ann Philion-Dufour, LCSW

• Family Medicine Physician in Portland, ME
• Providers in Portland, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.