KEVIN PHAN
NPI 1174907273
Optometrist in New York, CA
About Kevin Phan NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEVIN PHAN (NPI 1174907273) is an individual optometrist in New York, California, licensed in New York (008319) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kevin Phan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Kevin Phan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10019
- Reassigned Medicare billing, New York enrollment
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Kevin Phan's NPI number?
The NPI number for Kevin Phan is 1174907273. It was assigned to this individual provider in the NPPES registry on July 17, 2015.
Where is Kevin Phan located?
Kevin Phan practices at 165 East 87th St 1rw, New York, CA 10128. The listed phone number is (510) 396-8755.
What is Kevin Phan's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Kevin Phan enrolled in Medicare?
Yes. Kevin Phan is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kevin Phan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Phan reassigns Medicare benefits to 2 organizations: Andrea Optical Inc. (New York, NY) 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 Kevin Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kevin Phan accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Kevin Phan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kevin Phan was last updated on February 11, 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.
# Kevin Phan · NPI 1174907273
Optometrist provider in New York, California. Individual provider, active in the CMS NPPES registry since July 17, 2015.
## Identity
- **NPI:** 1174907273 (Entity type: Individual)
- **Enumerated:** July 17, 2015
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 008319 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 165 EAST 87TH ST 1RW, New York, CA 10128
- **Phone:** (510) 396-8755
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Andrea Optical Inc. (NPI 1922420306, New York, NY); Permanente Medical Group Inc (NPI 1548343510, Stockton, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 11, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1174907273) · Data from the CMS NPPES public registry.