Kimberly Phan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2176 Salk Ave Ste 200
Carlsbad, CA 92008

Phone

(858) 927-5527

NPI assigned

Jun 12, 2019

Last updated

Jul 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kphan319848@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  dba Scripps Clinic

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment Care Compare group
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  dba Scripps Home Health Care Services

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD
• Scripps Health

  dba Scripps Coastal Medical Center

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1881636108

  Physician Assistant

  NPD
• Scripps Health

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1427034990
  NPD (past)

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

• Rancho Bernardo Healthcare LLC

  dba Seaport Scripps Home Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1750906954
  Care Compare affiliation
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation
• Scripps Health

  dba Scripps Green Hospital

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  Care Compare affiliation
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1912566910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 SALK AVE STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 SALK AVE STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "858-927-5527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2176 Salk Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "92008",
            "country_code": "US",
            "telephone_number": "858-927-5527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanh Minh Pham, PHARMD
• Cynthia Thai Pham
• Dorrance Pham, PHARMD
• Michael Trung Pham, DO
• Tram Pham, BCBA
• Minh Ngoc Phan, DMD
• Thi Thi Cong Phan, DDS
• Alyssha Phanord
• Pharmaca Integrative Pharmacy, Inc. (Pharmaca Integrative Pharmacy)
• Kathleen Phelps, L.C.S.W.

• Physician Assistant in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.