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DR. PHUNG DINH PHAN D.O.
NPI 1043567407
Family Medicine in Lakeland, FL

Active since August 04, 2012PECOS EnrolledAccepts Medicare Assignment
1625 SHEPHERD RD, LAKELAND, FL 33811(863) 284-1626 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 22, 2020, Dec 20, 2020 (2 updates tracked since 2020).

About Dr. Phung Dinh Phan D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PHUNG DINH PHAN D.O. (NPI 1043567407) is an individual family medicine provider in Lakeland, Florida, licensed in Florida (OS20770) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS, is affiliated with Lakeland Regional Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1043567407
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PHUNG DINH PHANCredential: D.O.
Location Address1625 SHEPHERD RDLakeland, FL 33811-2122
Mailing AddressUnit 28038 Bld 700Apo, AE 09112 · (314) 590-3904
Phone(863) 284-1626
Sole ProprietorNo
Medical School CMSLake Erie Col Of Osteopathic Medicine, BradentonGraduated 2012
Enumeration DateAugust 4, 2012
Last NPPES UpdateMay 30, 20242 updates tracked since enumeration
NPPES CertifiedMay 30, 2024
✔ NPI 1043567407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in FL · OS20770✔ Licensed in NE · 1141
Definition

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.

Also ListedMilitary Health Care ProviderTaxonomy 171000000X · License 1141 (NE)
1625 SHEPHERD RD, Lakeland, FL 33811
Open in Google Maps ↗

Secondary Practice Locations 3

Location 13030 Harden BlvdLakeland, FL 33803-7952 · Phone (863) 284-5000
Location 2Unit 28130, Building 475APO, AE 09114 · Phone (314) 590-3176
Location 34710 S Florida AveLakeland, FL 33813-2165 · Phone (863) 284-5000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Phung Dinh Phan D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355616855
PECOS Enrollment IDI20240328001971
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lakeland Regional Medical Center

Acute Care Hospitals · Lakeland, FL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100157
Location1324 Lakeland Hills BlvdLakeland, FL 33805 · Polk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33811 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phung Phan's NPI number?

The NPI number for Phung Phan is 1043567407. It was assigned to this individual provider in the NPPES registry on August 4, 2012.

Where is Phung Phan located?

Phung Phan practices at 1625 Shepherd Rd, Lakeland, FL 33811. The listed phone number is (863) 284-1626.

What is Phung Phan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Phung Phan enrolled in Medicare?

Yes. Phung Phan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Phung Phan accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Phung Phan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Phung Phan affiliated with any hospitals?

According to CMS data, Phung Phan is affiliated with Lakeland Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Phung Phan was last updated on May 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.