Individual provider Active NPI

Hai T Pham, D.P.M.

  • Podiatrist
  • Kent, OH
National Provider Identifier
1659359768
Registry record updated Oct 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36-00-3280 -P Issued in OH
Practice address
1221 S. Water Street
Suite a
Kent, OH 44240
Phone
(330) 474-0500
Fax
(330) 474-0501
NPI assigned
Jan 9, 2006
Last updated
Oct 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36-00-3280 -P OH Primary

Addresses

Primary practice location

1221 S. Water Street
Suite a
Kent, OH 44240

Mailing address

1221 S. Water Street
Suite a
Kent, OH 44240
Phone (330) 474-0500

Other identifiers 2

IdentifierTypeStateIssuer
2415247MedicaidOH
1659359768OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20040729000294 OH Practitioner - Podiatry 8325018153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Plus Family Foot and Ankle CenterGroup PAC ID 0345261210, 2 clinicians

Practice addresses (Care Compare)

1221 S Water St
Suite a
Kent, OH 44240-3878
Phone (330) 474-0500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Family Foot and Ankle Center Podiatrist CurrentSince Jun 2, 2003 Accepting new patients
Wound Care Associates of Akron, Inc Podiatrist Past Accepting new patients

Locations

1221 S Water St
Ste A
Kent, OH 44240
Phone (330) 474-0500

Interoperability endpoints

  • Direct secure messaging: hpham36898@ehrdirect.uhhospitals.org

Organizations & group practices 2

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 1

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317427200000",
    "number": "1659359768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S. WATER STREET",
            "address_2": "SUITE A",
            "city": "KENT",
            "state": "OH",
            "postal_code": "44240",
            "telephone_number": "330-474-0500",
            "fax_number": "330-474-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S. WATER STREET",
            "address_2": "SUITE A",
            "city": "KENT",
            "state": "OH",
            "postal_code": "44240",
            "telephone_number": "330-474-0500",
            "fax_number": "330-474-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HAI",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2011-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-3280 -P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2415247",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659359768",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.