JONATHAN PHAM FNP-BC
NPI 1053298406
Nurse Practitioner - Family in Fountain Valley, CA

Q: What is Jonathan Pham's NPI number?

The NPI number for Jonathan Pham is 1053298406. It was assigned to this individual provider in the NPPES registry on August 18, 2025.

Q: What is Jonathan Pham'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 Jonathan Pham was last updated on August 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 18, 2025PECOS EnrolledAccepts Medicare Assignment

17150 EUCLID ST STE 200, FOUNTAIN VALLEY, CA 92708(714) 395-4595 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jonathan Pham Fnp-bc NPPES

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

JONATHAN PHAM FNP-BC (NPI 1053298406) is an individual family provider in Fountain Valley, California, licensed in California (95036371) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1053298406

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameJONATHAN PHAMCredential: FNP-BC

Location Address17150 EUCLID ST STE 200Fountain Valley, CA 92708-4092

Mailing Address12772 9th StGarden Grove, CA 92840-5406 · (714) 787-7567

Phone(714) 395-4595

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 18, 2025

NPPES CertifiedAugust 18, 2025

✔ NPI 1053298406 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 · 95036371

17150 EUCLID ST STE 200, Fountain Valley, CA 92708

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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

Jonathan Pham Fnp-bc 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 ID1951895069

PECOS Enrollment IDI20251216000440

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 92708 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

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Other Providers at the Same Location NPPES 19

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

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