Active NPI
Alexandria T Phan, M.D.
- Medical Oncology Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- L3069
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-0505
- Fax
- (414) 955-0231
- NPI assigned
- Jul 17, 2006
- Last updated
- Jan 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L3069 | TX | |
| Hematology & Oncology Physician | 207RH0003X | L3069 | TX | |
| Hematology & Oncology Physician | 207RH0003X | 23373-875 | WI | |
| Medical Oncology Physician | 207RX0202X | L3069 | TX | Primary |
| Medical Oncology Physician | 207RX0202X | MD2016-0653 | NM | |
| Medical Oncology Physician | 207RX0202X | 23373-875 | WI |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-0505
Other practice location 1
3730 Kirby Dr Ste 1200
Houston, TX 77098-3985
Phone (346) 704-4016
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 147345602 | Medicaid | TX | |
| 8J1932 | Other | TX | BCBS |
| P01186458 | Other | TX | RR MEDICARE |
| 147345603 | Medicaid | TX | |
| 1821016148 | Medicaid | WI | |
| 1821016148 | Other | TX | BLUE CROSS BLUE SHIELD |
| 8EE349 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, GA, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666
8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23373-875 | WI | MD | Hematology & Oncology Physician |
| MD2016-0653 | NM | MD | Medical Oncology Physician |
| L3069 | TX | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Health Science Center at Tyler-Facility-Physician | Current | Accepting new patients | |
| City of Hope Medical Group of Georgia LLC | Internal Medicine | Current | Accepting new patients |
| University of Texas Health Science Center at Tyler-Facilty-Physician | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
| Ut Physicians | Internal Medicine | Past | Accepting new patients |
| Ut Physicians | Past | Accepting new patients | |
| The Medical College of Wisconsin Inc | Past | Accepting new patients |
Locations
600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334
62742 Collections Ctr Dr
Chicago, IL 60693
102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201
11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
Interoperability endpoints
- aphan599038@direct.froedtert.com
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- Internal Medicine Physician
- Newnan, GA
- NPI 1447520333
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Tyler, TX
- NPI 1063400778
-
dba UT Health East Texas Physicians Overton
- Rural Health Clinic/Center
- Overton, TX
- NPI 1689496812
-
- Case Management Agency
- Milwaukee, WI
- NPI 1649521105
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Froedtert Menomonee Falls Hospital
- General Acute Care Hospital
- Menomonee Falls, WI
- NPI 1609822881
-
dba CDI-Froedtert Memorial Lutheran Hospital
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1255334173
-
- General Acute Care Hospital
- Pleasant Prairie, WI
- NPI 1003831132
-
dba Froedtert Holy Family Memorial Hospital
- General Acute Care Hospital
- Manitowoc, WI
- NPI 1700998697
-
dba Froedtert West Bend Hospital
- General Acute Care Hospital
- West Bend, WI
- NPI 1851336044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1821016148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-0505",
"fax_number": "414-955-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-0505",
"fax_number": "414-955-0231"
}
],
"practiceLocations": [
{
"address_1": "3730 Kirby Dr Ste 1200",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770983985",
"country_code": "US",
"telephone_number": "346-704-4016",
"fax_number": "281-545-3953",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAN",
"first_name": "ALEXANDRIA",
"middle_name": "T",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "L3069",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TX",
"license": "L3069",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "WI",
"license": "23373-875",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "TX",
"license": "L3069",
"primary": true
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "NM",
"license": "MD2016-0653",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "WI",
"license": "23373-875",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147345602",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8J1932",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01186458",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147345603",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821016148",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1821016148",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8EE349",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.