Individual provider Active NPI

Michelle Pham

  • Student in an Organized Health Care Education/Training Program
  • Syracuse, NY
National Provider Identifier
1871353565
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1419 Salt Springs Rd
Syracuse, NY 13214-1301
Phone
(267) 416-2319
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 035032 NY
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1419 Salt Springs Rd
Syracuse, NY 13214-1301

Mailing address

1419 Salt Springs Rd
Syracuse, NY 13214-1301
Phone (267) 416-2319

Other practice location 1

33-57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20260127002945 NY Practitioner - Physician Assistant 9436637931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical Associates PCGroup PAC ID 0345144978, 229 clinicians

Practice addresses (Care Compare)

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6622

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
035032NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. CurrentSince Jan 11, 2026 Accepting new patients
United Medical Associates PC CurrentSince Jan 11, 2026 Accepting new patients

Locations

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

Organizations & group practices 2

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": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1871353565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SALT SPRINGS RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141301",
            "telephone_number": "267-416-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 SALT SPRINGS RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141301",
            "telephone_number": "267-416-2319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33-57 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "137902107",
            "country_code": "US",
            "telephone_number": "607-763-6412",
            "fax_number": "607-763-5854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035032",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.