PHUNG KIM PHAM
NPI 1093352007
Nurse Practitioner - Family in Falls Church, VA

Q: What is Phung Pham's NPI number?

The NPI number for Phung Pham is 1093352007. It was assigned to this individual provider in the NPPES registry on December 9, 2019.

Q: What is Phung 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 Phung Pham was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since December 09, 2019PECOS Enrolled

107 PARK PL, FALLS CHURCH, VA 22046(703) 241-8811 Get Directions Write a Review

NPPES record last updated: February 4, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 4, 2026, Jan 23, 2026, Dec 9, 2019 (3 updates tracked since 2019).

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About Phung Kim Pham NPPES

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

PHUNG KIM PHAM (NPI 1093352007) is an individual family provider in Falls Church, Virginia, licensed in Virginia (0024194572) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1093352007

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NamePHUNG KIM PHAM

Location Address107 PARK PLFalls Church, VA 22046-4513

Mailing Address9410 Luke DrManassas Park, VA 20111-8210 · (571) 274-7685

Phone(703) 241-8811

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateDecember 9, 2019

Last NPPES UpdateFebruary 4, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2026

✔ NPI 1093352007 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 VA · 0024194572

107 PARK PL, Falls Church, VA 22046

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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 (PECOS)

Phung Kim Pham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274014519

PECOS Enrollment IDI20260224004626

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 22046 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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 5

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

JENNIFER L URBACH LPC

Counselor (Professional)