Alexander Phan, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201900297NP-PP Issued in OR

Practice address

1350 NE 122ND Ave
Portland, OR 97230

Phone

(503) 408-7008

NPI assigned

Jun 11, 2013

Reactivated

Jan 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Portland Hospital, Portland, OR, CCN 380060

Merit-based Incentive Payment System (MIPS)

Final score

92 of 100Reported as group

Quality

84.7

Promoting interoperability

100

Improvement activities

40

Cost

79.21

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aphan154728@direct.ohsu.edu

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.

• Portland Adventist Medical Center

  • Family Medicine Physician
  • Portland, OR
  • NPI 1750091021
  Medicare reassignment Care Compare group NPD
• Portland Adventist Medical Center

  • Family Medicine Physician
  • Portland, OR
  • NPI 1215910302
  Medicare reassignment NPD
• Portland Adventist Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Portland, OR
  • NPI 1316502719
  NPD
• Portland Adventist Medical Center

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1437925310
  NPD

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

• Portland Adventist Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1952749087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302011",
            "telephone_number": "503-408-7008",
            "fax_number": "503-408-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-408-7008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 NE Division St",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970304617",
            "country_code": "US",
            "telephone_number": "503-666-3808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4101 NE Division St",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970304617",
            "country_code": "US",
            "telephone_number": "503-666-3808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ALEXANDER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2019-04-14",
        "deactivation_date": "2019-01-13",
        "reactivation_date": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201900297NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274147",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trung Duc Pham, PRX
• Tuan Pham, MD
• Victor Nguyen Pham, M.D.
• Xuan Phuong Khanh Pham
• Yen Pham
• An Hoang Phan
• Andrew Kyanh Phan, D.M.D.
• Brian Gia Son Phan, DMD
• Edward Nguyen Khoi Phan, PHARM.D
• Francis Thanh Phan, M.D.

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.