Individual provider Active NPI

Tuan Phung, PA-C

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1659103653
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18029 Issued in TX
Practice address
5228 W Plano Pkwy
Plano, TX 75093-5005
Phone
(972) 250-5700
NPI assigned
Aug 17, 2024
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18029 TX Primary

Addresses

Primary practice location

5228 W Plano Pkwy
Plano, TX 75093-5005

Mailing address

6205 Red Cedar Cir
Fort Smith, AR 72916-8868
Phone (479) 719-0667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913001634 TX Practitioner - Physician Assistant 3375083587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Star Orthopedic Institute LLCGroup PAC ID 7618392424, 22 clinicians

Practice addresses (Care Compare)

5228 W Plano Pkwy
Plano, TX 75093-5005
Phone (972) 250-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: tuan.phung.1@31411.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1723852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1659103653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 RED CEDAR CIR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729168868",
            "telephone_number": "479-719-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 W PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935005",
            "telephone_number": "972-250-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "TUAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-17",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.