Jonathan Nguyen-Khoi Pham, OD

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

39474 Issued in CA

Practice address

4150 Clement Street
Eye Clinic
San Francisco, CA 94121-1563

Phone

(410) 221-4810

NPI assigned

Oct 26, 2021

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

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Community HealthGroup PAC ID 1658349824, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Bay Area Community Health

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1780054379
  Medicare reassignment Care Compare group NPD
• Bay Area Community Health

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1184791998
  NPD
• Bay Area Community Health

  • Federally Qualified Health Center (FQHC)
  • Fremont, CA
  • NPI 1942387188
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1750045720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CLEMENT ST APT 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211640",
            "telephone_number": "510-364-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT STREET",
            "address_2": "EYE CLINIC",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "410-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JONATHAN",
        "middle_name": "NGUYEN-KHOI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "39474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.pham2@va.gov",
            "affiliation": "N",
            "endpointDescription": "E-mail address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4150 Clement Street",
            "address_2": "Eye Clinic",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Duyen Phan Ky Pham
• Hai Hoang Nguyen Pham, M.D.
• Hieu D Pham, MD, DDS
• Hoang Thanh Pham, DC
• John Pham, PHARMD
• Kathy Pham
• Katlyn Pham
• Katy Caroline Pham, MD
• Kiet 206-322-7676, X6204 Pham, EDS
• Linda Pham, DOCTOR OF PHARMACY

• Low Vision Rehabilitation Optometrist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Low Vision Rehabilitation Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.