MR. ANDY PHUNG D.O.
NPI 1003013756
Family Medicine in High Point, NC


Quality Rating: 90.1 out of 100 score

NPI Status: Active since June 27, 2007

Contact Information

507 N LINDSAY ST
HIGH POINT, NC
ZIP 27262
Phone: (336) 883-0029
Fax: (336) 883-0867

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  • Individual
  • Male
  • Years of Experience 17
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About ANDY PHUNG

Andy Phung is a primary care provider established in High Point, North Carolina and his medical specialization is Family Medicine with more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1003013756 assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 2010-00375 (NC). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1003013756
Provider Name
MR. ANDY PHUNG D.O.
Gender
Male
Entity Type
Individual
Location Address
507 N LINDSAY ST HIGH POINT, NC 27262
Location Phone
(336) 883-0029
Location Fax
(336) 883-0867
Mailing Address
507 N LINDSAY ST HIGH POINT, NC 27262
Mailing Phone
(336) 883-0029
Mailing Fax
(336) 883-0867
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
06-27-2007
Last Update Date
01-21-2021
Code Navigator

A primary care provider (PCP) like Andy Phung sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Andy Phung is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.1, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.8 for a new patient copayment and $25.2 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
2010-00375
License State
NC
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

5101017157 (MI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross and Blue Shield of NC

    • Blue Advantage Bronze | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
    • Blue Advantage Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
    • Blue Advantage Bronze | HSA Eligible | Integrated | Nationwide Doctors - PPO
    • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
    • Blue Advantage Catastrophic | 3 PCP $35 | Integrated | Nationwide Doctors - PPO
    • Blue Advantage Gold | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
    • Blue Advantage Gold Standard | Nationwide Doctors - PPO
    • Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
    • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
    • Blue Advantage Silver Secure | $15 PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
    • Blue Advantage Silver Standard | Nationwide Doctors - PPO
    • Blue Local Bronze | $60 PCP | $20 Tier 1 Rx | with Atrium Health - EPO
    • Blue Local Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Atrium Health - EPO
    • Blue Local Bronze | HSA Eligible | Integrated | with Atrium Health - EPO
    • Blue Local Bronze Standard | with Atrium Health - EPO
  • Cigna Healthcare

    • Connect Bronze 0 Indiv Med Deductible - HMO
    • Connect Bronze 5500 Indiv Med Deductible - HMO
    • Connect Bronze 6500 Indiv Med Deductible - HMO
    • Connect Bronze 9450 Indiv Med Deductible - HMO
    • Connect Bronze CMS Standard - HMO
    • Connect Gold CMS Standard - HMO
    • Connect Silver 1500 Indiv Med Deductible - HMO
    • Connect Silver 2500 Indiv Med Deductible Enhanced Diabetes Care - HMO
    • Connect Silver 3500 Indiv Med Deductible - HMO
    • Connect Silver 4500 Indiv Med Deductible - HMO
    • Connect Silver CMS Standard - HMO
  • UnitedHealthcare

    • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
    • UHC Bronze Essential ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
    • UHC Bronze Standard (No Referrals) - HMO
    • UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, No Referrals) - HMO
    • UHC Bronze Value HSA (No Referrals) - HMO
    • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
    • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
    • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, No Referrals) - HMO
    • UHC Gold Standard (No Referrals) - HMO
    • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, No Referrals) - HMO
    • UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals) - HMO
    • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care + $0 PCP Visits, $5 Tier 2 Rx, No Referrals) - HMO
    • UHC Silver Standard (No Referrals) - HMO
    • UHC Silver Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, No Referrals) - HMO
    • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • WellCare of North Carolina

    • Standard Expanded Bronze WellCare - PPO
    • Standard Gold WellCare - PPO
    • Standard Silver WellCare - PPO
    • WellCare Secure Health Bronze - PPO
    • WellCare Secure Health Gold - PPO
    • WellCare Secure Health Silver - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Andy Phung is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 840336723

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20101015001073

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 27262 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.2
  • Minimum New Patient Price $56.51
  • Maximum New Patient Price $172.65
  • Average New Patient Copayment $21.8
  • Minimum New Patient Copayment $14.12
  • Maximum New Patient Copayment $43.16

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.83
  • Minimum Established Patient Price $17.43
  • Maximum Established Patient Price $140.98
  • Average Established Patient Copayment $25.2
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $35.24

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 90.1 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 67

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003013756
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003016710
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 6 + 7 + 1 + 0 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003013756 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1932217239 THOMAS E JARRETT M.D.
Individual
Internal Medicine507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1083638860 LENIN J PETERS M.D.
Individual
Internal Medicine (Gastroenterology)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1497739866 VENKATA RAMANA CHALLA MD
Individual
Pathology (Anatomic Pathology)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1164579876 VAMSEE P PARUCHURI M.D.
Individual
Internal Medicine507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1184111866MRS. PRIYA P VARGHESE NP-C
Individual
Nurse Practitioner507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1730283151BETHANY MEDICAL CENTER
Organization
Clinic/Center (Endoscopy)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1184952277 PHALAN LARESE BOLDEN NP
Individual
Nurse Practitioner (Family)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1831522192 KIMBERLY WALKER TAYLOR FNP-C
Individual
Nurse Practitioner (Family)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1558463471 JOHN S MITCHELL MD
Individual
Family Medicine507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1396083820LJP ANESTHESIA SERVICES, PLLC
Organization
Nurse Anesthetist, Certified Registered507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1629187281 PATRICK J WATTERSON PA-C
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1720026974DR. FERNANDO ALBERTO SANCHEZ-BRUGAL MD
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1770176182 KATELIN STARRE NP
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1972565646DR. JOHN BOND MURPHY JR. MD
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1225003353DR. SOHAIL BAZEL M.D.
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1487610713DR. ANTHONY HALLOCK WHEELER M.D.
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1952404188BETHANY MEDICAL CENTER
Organization
Internal Medicine507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1043232606 WAYNE BEAUFORD M.D.
Individual
Internal Medicine (Pulmonary Disease)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1063521623 AMANDA T TAYLOR PA-C
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029
1316055700 DONALD K BULLA PA-C, RPH.
Individual
Pain Medicine (Pain Medicine)507 N LINDSAY ST
HIGH POINT, NC 27262
(336) 883-0029

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003013756, enumerated in the NPI registry as an "individual" on June 27, 2007

The provider is located at 507 N Lindsay St High Point, Nc 27262 and the phone number is (336) 883-0029

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 17 years of experience.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $87.2 with an average copayment of $21.8 for new patient appointments. Established patients should expect a typical charge of $100.83 and an average copayment of 25.2. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 27, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.