Vivian Phung, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ01422400 Issued in NJ

Practice address

2 Capital Way Ste 290
Pennington, NJ 08534-2521

Phone

(609) 303-4300

NPI assigned

Aug 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MA, PA, NJ3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vivian.phung.1@12833.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

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.

• Capital Health Medical Group

  • Internal Medicine Physician
  • Trenton, NJ
  • NPI 1437516887

  PA

  Medicare reassignment Care Compare group NPD
• Medical Care of Boston Management Corporation

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1437196359
  Medicare reassignment Care Compare group NPD
• Capital Health System

  • Endocrinology, Diabetes & Metabolism Physician
  • Hamilton, NJ
  • NPI 1740238062
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568868834
  NPD (past)

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1669804316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 290",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-303-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 290",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-303-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Centennial Dr",
            "address_purpose": "LOCATION",
            "city": "Peabody",
            "state": "MA",
            "postal_code": "019607901",
            "country_code": "US",
            "telephone_number": "978-531-7677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Stony Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Yardley",
            "state": "PA",
            "postal_code": "190675500",
            "country_code": "US",
            "telephone_number": "609-303-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "VIVIAN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2269832",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP020722",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01422400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vivian.phung.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Capital Way Ste 290",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vivian.phung.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1050 Stony Hill Rd",
            "city": "Yardley",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190675500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ganesha G Perumal, MS SLP-CCC
• Ashley Pfeffer, PA-C
• Thy T Pham, PA
• Julie Pharney, P.T.
• Huy Quang Phi, MD
• Robert Piccarillo, PT
• Thomas Donald Piepszak, D.O.
• Myrnaivette Pierson
• Kimberly Pilkiewicz, PSY.D.
• Susan Brady Pinto, L.P.C.

• Nurse Practitioner in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.