Ricky Nguyen Phan, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95006779 Issued in CA

Practice address

13591 Bowen St
Garden Grove, CA 92843-3223

Phone

(714) 261-7813

Fax

(714) 261-7813

NPI assigned

Jun 24, 2017

Last updated

Nov 29, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nguyen Hong Phan Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bel Air Critical Care Medical Group IncGroup PAC ID 4385917491, 12 clinicians

Arcadia Intensivist Group Inc.Group PAC ID 9537574223, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238
• California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arcadia Intensivist Group, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Arcadia, CA
  • NPI 1598361669
  Medicare reassignment Care Compare group NPD
• Bel Air Critical Care Medical Group, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Los Angeles, CA
  • NPI 1396268041
  Medicare reassignment Care Compare group NPD
• Meher F Tabatabai MD Inc

  • Infectious Disease Physician
  • Lynwood, CA
  • NPI 1104095942
  Medicare reassignment NPD
• St. Joseph Intensivist Group, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Burbank, CA
  • NPI 1801302484
  Medicare reassignment NPD
• Willow Brook Critical Care Medical Group, Inc

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1811520224
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  dba California Hospital Medical Center - Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  Care Compare affiliation
• Usc Arcadia Hospital

  • General Acute Care Hospital
  • Arcadia, CA
  • NPI 1508851288
  Care Compare affiliation

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1740700350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13591 BOWEN ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928433223",
            "telephone_number": "714-261-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13591 BOWEN ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928433223",
            "telephone_number": "714-261-7813",
            "fax_number": "714-261-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "RICKY",
        "middle_name": "NGUYEN",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95006779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NGUYEN",
            "last_name": "PHAN",
            "middle_name": "HONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mikey Phan
• Mindy Trieu Phan, D.M.D
• Nguyen Quoc Phan
• Quang Quoc Phan, M.D.
• Quoc Tran Duy Phan, PHARMD
• Sandy Diemly Phan, PHARMACIST
• Susie N Phan, PHARM.D
• Thaibinh Tran Phan, M.D.
• Thuan Ngoc Phan, D.C.
• Tuan Phan

• Acute Care Nurse Practitioner in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.