NPIMap

Individual provider Active NPI

Anthony Pham, M.D.

  • Hematology & Oncology Physician
  • Tigard, OR
National Provider Identifier
1790913994
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD176450 Issued in OR
Practice address
12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone
(971) 708-7600
Fax
(971) 371-5230
NPI assigned
Jun 25, 2009
Last updated
May 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP01695 RI
Hematology & Oncology Physician 207RH0003X 57041 MN
Hematology & Oncology Physician 207RH0003X MD176450 OR Primary

Addresses

Primary practice location

12123 SW 69TH Ave
Tigard, OR 97223-8514

Mailing address

1498 SE Tech Center PL Ste 240
Vancouver, WA 98683-5508
Phone (360) 597-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160616001182 WA Practitioner - Hematology/Oncology 1759538192 Reassigns benefits to 1 organization
I20160715001977 OR Practitioner - Hematology/Oncology 1759538192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Texas Medical Branch at Galveston, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600

210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889

265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LP01695RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 Past Accepting new patients
Northwest Cancer Specialists, PC PastSince Jul 1, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anthony.pham@compass.ikm.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1790913994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835508",
            "telephone_number": "360-597-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12123 SW 69TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238514",
            "telephone_number": "971-708-7600",
            "fax_number": "971-371-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01695",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "57041",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "MD176450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.