Active NPI
Nicholas Minh Pham, MD
- Pediatrics Physician
- Surprise, AZ
National Provider Identifier
1619980547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 28681
- Practice address
- 14239 W Bell Rd
Suite 112
Surprise, AZ 85374-2469 - Phone
- (623) 876-9983
- Fax
- (623) 876-9984
- NPI assigned
- Aug 14, 2006
- Last updated
- Jul 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 28681 | AZ | Primary |
Addresses
Primary practice location
14239 W Bell Rd
Suite 112
Surprise, AZ 85374-2469
Mailing address
14239 W Bell Rd
Suite 112
Surprise, AZ 85374-2469
Phone (623) 876-9983
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28681 | Other | AZ | AZ LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28681 | AZ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arbor Medical Partners, LLC | Pediatrics | Past | Accepting new patients |
| North Scottsdale Pediatric Associates | Pediatrics | Past | Accepting new patients |
| Surprise Pediatrics | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Legal Medicine
- Surprise, AZ
- NPI 1801893425
-
- Pediatrics Physician
- Scottsdale, AZ
- NPI 1023546082
-
- Pediatrics Physician
- Scottsdale, AZ
- NPI 1275797235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1619980547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14239 W BELL RD",
"address_2": "SUITE 112",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742469",
"telephone_number": "623-876-9983",
"fax_number": "623-876-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14239 W BELL RD",
"address_2": "SUITE 112",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742469",
"telephone_number": "623-876-9983",
"fax_number": "623-876-9984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "NICHOLAS",
"middle_name": "MINH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "28681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ LICENSE",
"identifier": "28681",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.