AMY QUYNHPHI PHAN FNP-C
NPI 1053040329
Nurse Practitioner - Family in San Diego, CA

Q: What is Amy Phan's NPI number?

The NPI number for Amy Phan is 1053040329. It was assigned to this individual provider in the NPPES registry on June 9, 2022.

Q: What is Amy Phan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Phan was last updated on June 9, 2022. 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.

Active since June 09, 2022PECOS EnrolledAccepts Medicare Assignment

5575 RUFFIN RD STE 100, SAN DIEGO, CA 92123(858) 277-2744 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Amy Quynhphi Phan Fnp-c NPPES

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

AMY QUYNHPHI PHAN FNP-C (NPI 1053040329) is an individual family provider in San Diego, California, licensed in California (95019164) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1053040329

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMY QUYNHPHI PHANCredential: FNP-C

Location Address5575 RUFFIN RD STE 100San Diego, CA 92123-1361

Mailing Address4852 Clairemont DrSan Diego, CA 92117-2705

Phone(858) 277-2744

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 9, 2022

NPPES CertifiedJune 9, 2022

✔ NPI 1053040329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95019164

5575 RUFFIN RD STE 100, San Diego, CA 92123

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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

Amy Quynhphi Phan Fnp-c 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 ID143601070

PECOS Enrollment IDI20220722001893

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VITHYA SAIRAM M.D

General Practice