NICOLE PHAM
NPI 1083289649
Podiatrist - Foot & Ankle Surgery in Manteca, CA
About Nicole Pham NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE PHAM (NPI 1083289649) is an individual foot & ankle surgery provider in Manteca, California, licensed in California (E6082) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of California School Of Podiatric Medicine (2022).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nicole Pham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Nicole Pham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Manteca, CA 95336
- Reassigned Medicare billing, California enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
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 Nicole Pham's NPI number?
The NPI number for Nicole Pham is 1083289649. It was assigned to this individual provider in the NPPES registry on May 25, 2021.
Where is Nicole Pham located?
Nicole Pham practices at 1140 Norman Dr Ste 1, Manteca, CA 95336. The listed phone number is (209) 823-2700.
What is Nicole Pham's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Nicole Pham enrolled in Medicare?
Yes. Nicole Pham is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Nicole Pham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Pham reassigns Medicare benefits to Nicole Pham DPM Professional Corporation (Manteca, 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 Nicole Pham'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 Nicole Pham was last updated on November 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Nicole Pham · NPI 1083289649
Foot & Ankle Surgery provider in Manteca, California. Individual provider, active in the CMS NPPES registry since May 25, 2021.
## Identity
- **NPI:** 1083289649 (Entity type: Individual)
- **Enumerated:** May 25, 2021
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** E6082 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1140 NORMAN DR STE 1, Manteca, CA 95336-5900
- **Phone:** (209) 823-2700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Nicole Pham DPM Professional Corporation (NPI 1538040001, Manteca, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** California School Of Podiatric Medicine, class of 2022
## Record status
- **NPPES last updated:** November 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1083289649) · Data from the CMS NPPES public registry.