Kim-Tien Quoc Pham, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61073230 Issued in WA

Practice address

2709 Hemlock St
Bremerton, WA 98310-2623

Phone

(360) 782-6000

Fax

(360) 782-6099

NPI assigned

Jun 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpham242298@fhsce.catholichealth.net
• FHIR API: https://api.platform.athenahealth.com/21373/brand/1/csg/1/fhir/r4

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.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment Care Compare group NPD
• Dispatchhealth Washington PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1013490507
  Medicare reassignment NPD
• Virginia Mason Medical Center

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD
• Tran Urgent Care & Wellness Centers LLC

  • Urgent Care Clinic/Center
  • Tacoma, WA
  • NPI 1003446857
  NPD (past)
• Dispatchhealth Advanced Care - Washington PC

  • Hospitalist Physician
  • Denver, CO
  • NPI 1093324659
  NPD (past)
• Impact Health Biometric Testing, Inc.

  • Clinical Medical Laboratory
  • King of Prussia, PA
  • NPI 1588132013
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Care Compare affiliation

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1851918692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 HEMLOCK ST",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102623",
            "telephone_number": "360-782-6000",
            "fax_number": "360-782-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 HEMLOCK ST",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102623",
            "telephone_number": "360-782-6000",
            "fax_number": "360-782-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIM-TIEN",
        "middle_name": "QUOC",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-27",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61073230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165705",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpham242298@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2709 Hemlock St",
            "city": "Bremerton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983102623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Denise Petersen
• Jennie Peterson
• Mike Peterson
• Nancy G Peterson, RN
• Terry Pexton, DO
• Minhanh Trinh Pham, PT, DPT
• Isabelle Phan, PHARMD
• Jessica L Phares
• Setareh Phillips-Dwyer
• Lynn Phillips, LMFT

• Family Nurse Practitioner in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.

Verify at the official NPI Registry.