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JOHNNY PHAM FNP
NPI 1205578622
Nurse Practitioner - Family in Pomona, CA

Active since April 07, 2022PECOS EnrolledAccepts Medicare Assignment
86.35/100
CMS Quality Rating
775 E FOOTHILL BLVD, POMONA, CA 91767(909) 621-6708 Get Directions Write a Review

NPPES record last updated: September 2, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 2, 2022, Apr 7, 2022 (2 updates tracked since 2022).

About Johnny Pham Fnp NPPES

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

JOHNNY PHAM FNP (NPI 1205578622) is an individual family provider in Pomona, California, licensed in California (95020474) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1205578622
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJOHNNY PHAMCredential: FNP
Location Address775 E FOOTHILL BLVDPomona, CA 91767-1223
Mailing Address775 E Foothill BlvdPomona, CA 91767-1223 · (909) 621-6708
Phone(909) 621-6708
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 7, 2022
Last NPPES UpdateSeptember 2, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2022
✔ NPI 1205578622 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 · 95020474
775 E FOOTHILL BLVD, Pomona, CA 91767
Open in Google Maps ↗

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

Johnny Pham Fnp 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 ID9234506486
PECOS Enrollment IDI20221101002582
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Johnny Pham reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Minuteclinic Diagnostic Medical Group Of Orange County Inc
28 mi
Nurse Practitioner
14330 CULVER DR
Irvine, CA 92604
  • Reassigned Medicare billing, California enrollment
  • 212 clinicians in this Medicare group
NPI 1104013879 (866) 389-2727
Minuteclinic Primary Care California
28 mi
Family
14330 CULVER DR
Irvine, CA 92604
  • Reassigned Medicare billing, California enrollment
  • 71 clinicians in this Medicare group
NPI 1083421614 (866) 389-2727
Minuteclinic Diagnostic Medical Group Of California Inc
35 mi
Family
511 N HOLLYWOOD WAY
Burbank, CA 91505
  • Reassigned Medicare billing, California enrollment
  • 236 clinicians in this Medicare group
NPI 1033309372 (866) 389-2727
Minuteclinic Diagnostic Medical Group Of San Diego Inc
100 mi
Family
2760 FLETCHER PKWY
El Cajon, CA 92020
  • Reassigned Medicare billing, California enrollment
  • 212 clinicians in this Medicare group
NPI 1568659233 (866) 389-2727

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 91767 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.

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.

86.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.06
Improvement Activities40
Cost90.15

Other Providers at the Same Location NPPES 9

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

DAVIS LE
Pharmacist
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708
ROUENH JANE GONZALES GOCE FNP-C
Nurse Practitioner (Family)
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708
ALKA KURUP RPH
Pharmacist
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708
GRETA WANGANIA
Nurse Practitioner (Family)
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708
NGOC-DIEM NGUYEN PHARMD
Pharmacist
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6798
JAMES BARR FNP
Nurse Practitioner (Family)
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 217-4105
GARFIELD BEACH CVS LLC
Pharmacy
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708
FINNEY JACOB
Pharmacist
775 E FOOTHILL BLVD
POMONA, CA 91767
Los Angeles County (909) 621-6708

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 Johnny Pham's NPI number?

The NPI number for Johnny Pham is 1205578622. It was assigned to this individual provider in the NPPES registry on April 7, 2022.

Where is Johnny Pham located?

Johnny Pham practices at 775 E Foothill Blvd, Pomona, CA 91767. The listed phone number is (909) 621-6708.

What is Johnny Pham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Johnny Pham enrolled in Medicare?

Yes. Johnny Pham 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 Johnny Pham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Johnny Pham reassigns Medicare benefits to 4 organizations: Minuteclinic Diagnostic Medical Group Of Orange County Inc (Irvine, CA), Minuteclinic Primary Care California (Irvine, CA), Minuteclinic Diagnostic Medical Group Of California Inc (Burbank, CA) and Minuteclinic Diagnostic Medical Group Of San Diego Inc (El Cajon, 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 Johnny 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 Johnny Pham was last updated on September 2, 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.