Individual provider Active NPI

Judy Ha Pham, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1801449616
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301507866 Issued in MI
Practice address
13210 E Jefferson Ave
Detroit, MI 48215-2704
Phone
(313) 335-3444
Fax
(313) 484-4998
NPI assigned
Jul 20, 2019
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301507866 MI Primary

Addresses

Primary practice location

13210 E Jefferson Ave
Detroit, MI 48215-2704

Mailing address

13210 E Jefferson Ave
Detroit, MI 48215-2704
Phone (313) 335-3444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20221010000265 MI Practitioner - Internal Medicine 4688050073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Physicians Group of Michigan, PLLCGroup PAC ID 1153735287, 13 clinicians

Practice addresses (Care Compare)

13210 E Jefferson Ave
Detroit, MI 48215-2704
Phone (313) 335-3444

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physicians Group of Michigan PLLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

13210 E Jefferson Ave
Detroit, MI 48215
Phone (313) 335-3444

Interoperability endpoints

  • Direct secure messaging: jpham845936@direct.hfhs.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1801449616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13210 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152704",
            "telephone_number": "313-335-3444",
            "fax_number": "313-484-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13210 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152704",
            "telephone_number": "313-335-3444",
            "fax_number": "313-484-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JUDY",
        "middle_name": "HA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-20",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301507866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.