Andy Phan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A75547 Issued in CA

Practice address

1014 San Juan Ave
Exeter, CA 93221-1312

Phone

(559) 592-7371

Fax

(559) 624-6590

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: andy.phan.1@6501.direct.athenahealth.com

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.

• Erick Madrigal, MD, Mba, Inc.

  dba Clinica Agua Viva

  • Family Medicine Physician
  • Lindsay, CA
  • NPI 1619519246
  NPD (past)
• Kaweah Delta Health Care District

  dba Kaweah Health Medical Center

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  NPD (past)
• Kaweah Delta Health Care District

  dba Kaweah Health Urgent Care

  • Urgent Care Clinic/Center
  • Visalia, CA
  • NPI 1790795458
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1710934088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 SAN JUAN AVE",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932211312",
            "telephone_number": "559-592-7371",
            "fax_number": "559-624-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 SAN JUAN AVE",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932211312",
            "telephone_number": "559-592-7371",
            "fax_number": "559-624-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ANDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A75547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Pengilly, ED.D.
• Stefan I Pentschev, M.D.
• Antonio Perez, AS
• Tammy Petrossian, RD, CSP, CNSD
• Binh Pham, BA
• Toni Michelle Pinkerton, LMFT
• Barbara Pitcock
• Purpose Driven Healthcare LLC
• Giselle Quinones
• Alma Verenice Quintero-Zermeno

• Pediatrics Physician in Exeter, CA
• Providers in Exeter, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.