Thomas S Pham, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME118627 Issued in FL

Practice address

2489 Diplomat Pkwy E
Cape Coral, FL 33909-5422

Phone

(239) 652-1800

Fax

(248) 655-0372

NPI assigned

Nov 4, 2005

Sex

Male

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 FL

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Aqua Dermatology of Florida, PA

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1538270335
  Medicare reassignment NPD
• Water'S Edge Dermatology, LLC

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1134148992
  Medicare reassignment NPD
• Naples Center for Dermatology & Riverchase Dermatology

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1538645775
  NPD
• Water'S Edge Dermatology, LLC

  • Clinical Medical Laboratory
  • Palm Beach Gardens, FL
  • NPI 1871542787
  NPD

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1790776995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800",
            "fax_number": "248-655-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800",
            "fax_number": "248-655-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THOMAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301069802",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME118627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathie-Lee Petsch, CCC-SLP
• Nathan Samuel Pettit, MS, LMHC, MCAP
• Gabrielle Pfeffer
• Ngoc Han Thi Pham, DPM
• Tan-Long Pham, MS, OD
• Nhi Thi-Hong Phan, MD
• Clarke Andrew Philips, PT, MHS
• Phillip Kraver DMD, PLLC
• David Alexander Phillips, DO
• Jane J Phillips, PA

• Dermatology Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.