Individual provider Active NPI

Jen-Jung Pan, M.D.

  • Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1811073166
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
54235 Issued in AZ
Practice address
1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone
(602) 521-5180
NPI assigned
Oct 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2009008670 MO
Gastroenterology Physician 207RG0100X N6556 TX
Gastroenterology Physician 207RG0100X 54235 AZ Primary

Addresses

Primary practice location

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837

Mailing address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone (602) 521-5180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 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
I20100907000953 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 0345386587 Reassigns benefits to 1 organization
I20171003006326 AZ Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Other (Physician) 0345386587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy45
Upper gastrointestinal (GI) endoscopy for acid reflux51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Jul 1, 2019 Accepting new patients
Ut Physicians Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Jul 1, 2019 Accepting new patients
Ut Physicians CurrentSince Jul 1, 2010 Accepting new patients
Banner - University Super Specialists LLC CurrentSince Oct 23, 2020 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1441 N 12th St
Ste 3
Phoenix, AZ 85006

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1441 N 12th St
Fl 2AND3
Phoenix, AZ 85006

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6431 Fannin St
#4234
Houston, TX 77030
Phone (713) 500-6677

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Interoperability endpoints

  • Direct secure messaging: jenj.pan@direct.memorialhermann.org

Organizations & group practices 6

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 1

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": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1811073166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "JEN-JUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2009008670",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "N6556",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "54235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.