Individual provider Active NPI

Hung T Pham, DO

  • Psychiatry Physician
  • Kansas City, MO
National Provider Identifier
1750760336
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2019003761 Issued in MO
Practice address
4400 Broadway Blvd Ste 300
Kansas City, MO 64111-3342
Phone
(816) 932-1711
Fax
(816) 932-1719
NPI assigned
May 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2019003761 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4400 Broadway Blvd Ste 300
Kansas City, MO 64111-3342

Mailing address

901 E 104TH St
Mailstop 400S
Kansas City, MO 64131
Phone (816) 932-1711

Other practice location 1

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 982-4908

Other practice location 2

3901 Rainbow Blvd # MS 4015
Kansas City, KS 66160
Phone (913) 588-6492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20190320001377 MO Practitioner - PsychiatryPractitioner - General Practice 6305156316 Reassigns benefits to 1 organization
I20220310000576 KS Practitioner - Psychiatry 6305156316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

4400 Broadway Blvd
Suite 300
Kansas City, MO 64111-3342
Phone (816) 932-1711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019003761MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Aug 16, 2021 Accepting new patients
Saint Lukes Hospital of Garnett Inc Past Accepting new patients

Locations

421 S Maple St
Garnett, KS 66032
Phone (785) 204-7105

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4400 Broadway Blvd
Ste 300
Kansas City, MO 64111

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: hpham414170@direct.saint-lukes.org

Organizations & group practices 2

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 3

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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1750760336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-932-1711",
            "fax_number": "816-932-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY BLVD STE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113342",
            "telephone_number": "816-932-1711",
            "fax_number": "816-932-1719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-982-4908",
            "fax_number": "269-985-4526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 Rainbow Blvd # MS 4015",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "66160",
            "country_code": "US",
            "telephone_number": "913-588-6492",
            "fax_number": "913-588-6414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HUNG",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-28",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2019003761",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.