Elizabeth Phung-Hart, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

SL1020 Issued in NV

Practice address

620 Shadow Lane
Las Vegas, NV 89106-4194

Phone

(702) 388-8436

Fax

(702) 388-8431

NPI assigned

May 13, 2014

Last updated

May 13, 2014By 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 names 1

• Elizabeth Phung Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Interventional Cardiology

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Joaquin Cardiology Medical Group IncGroup PAC ID 7911916499, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Dameron Hospital Hospital, Stockton, CA, CCN 050122
• Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ephunghart604317@hisp.ehr.sutterhealth.org

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.

• San Joaquin Cardiology Medical Group Inc

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1497785455
  Medicare reassignment Care Compare group NPD

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

• Dameron Hospital Association

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1538163886
  Care Compare affiliation
• Dameron Hospital Association

  • Primary Care Clinic/Center
  • Stockton, CA
  • NPI 1699195115

  Hospital

  Care Compare affiliation
• Lodi Memorial Hospital Association Inc

  dba Lodi Memorial Hospital

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  Care Compare affiliation
• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1649681636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-8436",
            "fax_number": "702-388-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-8436",
            "fax_number": "702-388-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG-HART",
        "first_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL1020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PHUNG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonny Phoumiphat
• Xsana Phoumiphat
• Mycole Whitney Phu-Muns
• Andy Phui, DMD
• Myra Phui
• Danny Phung, MS
• Jacqueline Phung, DO
• Mai My Phung
• Madison Phuong, PHARMD
• Woranut Phuwana Chorphaka

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.