KIMMY PHAN
NPI 1043843816
Occupational Therapist in Garden Grove, CA
About Kimmy Phan NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMMY PHAN (NPI 1043843816) is an individual occupational therapist in Garden Grove, California, licensed in California (19050) and active in the NPI registry since February 2020.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimmy Phan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kimmy Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Chino Hills, CA 91709
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Kimmy Phan's NPI number?
The NPI number for Kimmy Phan is 1043843816. It was assigned to this individual provider in the NPPES registry on February 19, 2020.
Where is Kimmy Phan located?
Kimmy Phan practices at 11911 West St, Garden Grove, CA 92840. The listed phone number is (714) 467-9816.
What is Kimmy Phan's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Kimmy Phan enrolled in Medicare?
Yes. Kimmy Phan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kimmy Phan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimmy Phan reassigns Medicare benefits to Southern California Permanente Medical Group (Chino Hills, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimmy Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimmy Phan was last updated on November 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.