Individual provider Active NPI

Phu T Pham, M.D.

  • Internal Medicine Physician
  • Springfield, VA
National Provider Identifier
1669454237
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101043884 Issued in VA
Practice address
7440 Spring Village Dr
Springfield, VA 22150-4446
Phone
(703) 923-4644
Fax
(703) 923-4625
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101043884 VA Primary

Addresses

Primary practice location

7440 Spring Village Dr
Springfield, VA 22150-4446

Mailing address

5525 Research Park Dr
4TH Floor
Baltimore, MD 21228-4873
Phone (703) 923-4644

Other identifiers 1

IdentifierTypeStateIssuer
010284121MedicaidVA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110223000064 DC Practitioner - Internal Medicine 6406037597 Reassigns benefits to 1 organization
Practice locations: Springfield, VA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

9401 Lee Hwy 400
Fairfax, VA 22031-1847
Phone (703) 383-4836

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince May 10, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince May 10, 2018 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Erickson Health Medical Group of Virginia PC Internal Medicine Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

9401 Route 29
Ste 400
Fairfax, VA 22031

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: phu.pham.1@8042.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1669454237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 RESEARCH PARK DR",
            "address_2": "4TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284873",
            "telephone_number": "703-923-4644",
            "fax_number": "703-923-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 SPRING VILLAGE DR",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221504446",
            "telephone_number": "703-923-4644",
            "fax_number": "703-923-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PHU",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101043884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010284121",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

Verify at the official NPI Registry.