Rosa Pham, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60969825 Issued in WA

Practice address

700 NE 87TH Ave
Vancouver, WA 98664-1913

Phone

(360) 882-2778

NPI assigned

May 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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

Oregon Health Sciences University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 46)

Interoperability endpoints

• Direct secure messaging: rpham14154@tvc-direct.org
• Direct secure messaging: rosa.pham.1@30646.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/30646/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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group NPD
• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• Zoomcare PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1851958797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ROSA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201808243NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60969825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138884",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Pham
• Khoa Dang Pham
• Kristine H Pham, DMD
• Luke Huy-Viet Pham, RDO
• Minh Pham, PHARM D.
• Tan Ba Pham, DMD
• Tu Pham, MD
• Long G Phan, PHARMACIST
• Khaled Rashad Pharaon, MD
• Pharmacy Corporation of America

• Family Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, 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 Nov 5, 2020; 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.