Kim-Anh Ngoc Pham, FNP-C

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Practice address

201 Monarch Dr
Liverpool, NY 13088-4506

Phone

(315) 615-4464

NPI assigned

Jul 31, 2020

Last updated

Mar 4, 2025By the provider in NPPES

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

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kim-anh.pham.1@14940.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.

• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1063468239
  Medicare reassignment NPD
• Molina Healthcare of New York, Inc.

  • Nurse Practitioner
  • North Syracuse, NY
  • NPI 1134622970
  Medicare reassignment NPD
• New Health Medical New York PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1124460696
  Medicare reassignment NPD
• Syracuse Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1497796353
  Medicare reassignment NPD
• Integrative Family Health Haven East RN NP in Family Health PLLC

  • Family Medicine Physician
  • East Syracuse, NY
  • NPI 1790571255
  Medicare reassignment
• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD
• NC Medical of Ny PC

  • Primary Care Clinic/Center
  • Liverpool, NY
  • NPI 1649087263
  NPD
• Syracuse Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1184886988
  NPD

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1730799164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 WELLS AVE W",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122806",
            "telephone_number": "315-350-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MONARCH DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884506",
            "telephone_number": "315-615-4464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Wells Ave W",
            "address_purpose": "LOCATION",
            "city": "North Syracuse",
            "state": "NY",
            "postal_code": "132122806",
            "country_code": "US",
            "telephone_number": "315-350-0695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIM-ANH",
        "middle_name": "NGOC",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Perla, MD
• Kylee Peterson
• Stephanie Petrone, M. ED.
• Kathrin Petterelli
• Eric O Pettit, DDS
• Andrew Ian Philip, M.D.
• Physio One Physical Therapy PLLC
• Maryann Piazza, LCSW-R
• Traci Lynn Pier, LCSW
• Jennifer Pietricola, DC

• Primary Care Clinic/Center in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.