Nhat Pham, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP61194203 Issued in WA

Practice address

11603 State Ave Ste G
Marysville, WA 98271-8465

Phone

(360) 658-6800

NPI assigned

Jun 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Osteopathic Manipulative Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npham1998756@wm.providencedirect.org

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.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Providence Health & Services - Washington

  • Neurological Surgery Physician
  • Everett, WA
  • NPI 1639468259
  NPD

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

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1972098606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "360-658-6800",
            "fax_number": "360-658-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11603 STATE AVE STE G",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982718465",
            "telephone_number": "360-658-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-7389",
            "fax_number": "616-252-0841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NHAT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101024070",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61194203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Peterson, OTR/L
• Lyubov Petrushak
• Dylan Pettit
• Larry Lee Pevny, DENTURIST
• Jessica Pham
• Quoc-Cuong Pham, PHARM.D
• Debbie Phibbs, OT
• Philip Paulsen DDS
• Elizabeth Ann Kristine Phillips, DPT
• Amber Pickett

• Family Medicine Physician in Marysville, WA
• Providers in Marysville, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.