Individual provider Active NPI

Nga Van Pham, MD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1831118686
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A069545 Issued in CA
Practice address
1569 Lexann Ave
Suite 112
San Jose, CA 95121-1794
Phone
(408) 532-0105
Fax
(408) 532-0106
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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 A069545 CA Primary

Addresses

Primary practice location

1569 Lexann Ave
Suite 112
San Jose, CA 95121-1794

Mailing address

1569 Lexann Ave
Suite 112
San Jose, CA 95121-1794
Phone (408) 532-0105

Other identifiers 1

IdentifierTypeStateIssuer
00A695450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060404000215 CA Practitioner - Internal Medicine 9739197682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Top Care Medical Group IncGroup PAC ID 4183964919, 6 clinicians

Practice addresses (Care Compare)

1661 Burdette Dr
Suite I
San Jose, CA 95121-1681
Phone (408) 270-9642

2820 Alum Rock Ave
Suite 20
San Jose, CA 95127-5608
Phone (408) 729-2900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A069545CAMDInternal Medicine Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1831118686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "SUITE 112",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794",
            "telephone_number": "408-532-0105",
            "fax_number": "408-532-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "SUITE 112",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794",
            "telephone_number": "408-532-0105",
            "fax_number": "408-532-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NGA",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A069545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A695450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.