ETHAN T PHAN MD
NPI 1083076947
Hospitalist in Sacramento, CA
About Ethan T Phan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN T PHAN MD (NPI 1083076947) is an individual hospitalist provider in Sacramento, California, licensed in California (A170167) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In New Orleans (2016).
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 and accepts Medicare assignment
Ethan T Phan Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Ethan Phan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Sacramento, CA 95816
- Reassigned Medicare billing, California enrollment
- 1,191 clinicians in this Medicare group
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 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.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95816 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ethan Phan's NPI number?
The NPI number for Ethan Phan is 1083076947. It was assigned to this individual provider in the NPPES registry on March 22, 2016.
Where is Ethan Phan located?
Ethan Phan practices at 3000 Q St Fl 3, Sacramento, CA 95816. The listed phone number is (916) 733-3400.
What is Ethan Phan's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Ethan Phan enrolled in Medicare?
Yes. Ethan 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.
Which organizations bill Medicare for Ethan Phan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Phan reassigns Medicare benefits to 2 organizations: Dignity Health Medical Foundation (Sacramento, CA) and Permanente Medical Group Inc (Stockton, CA). Each 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 Ethan 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 Ethan Phan was last updated on December 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.
# Ethan T Phan, MD · NPI 1083076947
Hospitalist physician in Sacramento, California. Individual provider, active in the CMS NPPES registry since March 22, 2016.
## Identity
- **NPI:** 1083076947 (Entity type: Individual)
- **Enumerated:** March 22, 2016
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** A170167 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3000 Q ST FL 3, Sacramento, CA 95816-7058
- **Phone:** (916) 733-3400 · **Fax:** (916) 733-5940
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Dignity Health Medical Foundation (NPI 1700803418, Sacramento, CA); Permanente Medical Group Inc (NPI 1548343510, Stockton, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Louisiana State University School Of Medicine In New Orleans, class of 2016
## Record status
- **NPPES last updated:** December 12, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083076947) · Data from the CMS NPPES public registry.