Mimi Cao-Pham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0008351 Issued in MD

Practice address

7500 Hanover Pkwy Ste 204&205
Greenbelt, MD 20770-2010

Phone

(301) 232-3638

NPI assigned

Feb 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mimi.caopham@tpp.eclinicaldirectplus.com

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.

• Park Pediatrics

  • Pediatrics Physician
  • Takoma Park, MD
  • NPI 1285853135

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1689328833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 INNISBROOK DR",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051195",
            "telephone_number": "301-466-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HANOVER PKWY STE 204&205",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702010",
            "telephone_number": "301-232-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO-PHAM",
        "first_name": "MIMI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "C0008351",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Linda Campbell, LCPC
• Ja'Kayla Camper
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• Capital Hospice
• Capital Inhospital Consultants and Internal Medicine, PA
• Capital Nephrology, PC

• Physician Assistant in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.