Individual provider Active NPI

Jonathan Cuong Pham

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1699236299
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S8896 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-8840
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S8896 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210625000150 TX Practitioner - Emergency Medicine 7315348505 Reassigns benefits to 3 organizations
I20240627001711 LA Practitioner - Interventional Pain Management 7315348505 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C and M Medical Services IncGroup PAC ID 9436061553, 9 clinicians
La Pain Doctor IncGroup PAC ID 7618272121, 7 clinicians

Practice addresses (Care Compare)

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 869-5512

3220 S I 10 Service Rd W
Metairie, LA 70001-2007
Phone (504) 229-4866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as group
Quality
30
Promoting interoperability
91
Improvement activities
40
Cost
76.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Jul 15, 2022 Accepting new patients
La Urgent Care CurrentSince Oct 15, 2025 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Jul 1, 2021 Accepting new patients
La Pain Doctor Inc CurrentSince Jul 1, 2024 Accepting new patients
Integrative Emergency Services Physician Group PA Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
C & M Medical Services, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Ies Central Texas PLLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Meridian Health Partners PLLC Past Accepting new patients
Aec Physicians, LLC Past Accepting new patients

Locations

301 Walnut St
Amite, LA 70422
Phone (985) 748-7141

42276 Veterans Ave
Hammond, LA 70403
Phone (985) 549-6852

3820 Lapalco Blvd
Harvey, LA 70058

502 Rue de Sante
Ste 303
La Place, LA 70068
Phone (504) 473-5589

627 Belle Terre Blvd
La Place, LA 70068

12371 Highway 90
Luling, LA 70070

1645 Lutcher Ave
Ste 1200
Lutcher, LA 70071

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

5000 W Esplanade Ave
Metairie, LA 70006
Phone (504) 344-1945

4770 S I 10 Service Rd W
Ste 110
Metairie, LA 70001
Phone (504) 210-0890

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

3500 Gaston Ave
Dallas, TX 75246

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1500 S Main St
Fl 1
Ft Worth, TX 76104
Phone (817) 702-1451

101 Circle Dr
Hillsboro, TX 76645
Phone (254) 580-8500

2600 W Pleasant Run Rd
Lancaster, TX 75146
Phone (469) 297-5321

1011 N Galloway Ave
Mesquite, TX 75149
Phone (214) 320-7000

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

100 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-2000

Interoperability endpoints

  • Direct secure messaging: jonathan.pham@397.securemail.prognocis.com

Organizations & group practices 9

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.

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1699236299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JONATHAN",
        "middle_name": "CUONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S8896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.