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DR. TONY AI PHAM M.D.
NPI 1245419225
Psychiatry & Neurology - Psychiatry in Houston, TX

Active since October 26, 2007PECOS EnrolledAccepts Medicare Assignment
1315 ST JOSEPH PKWY 1307, HOUSTON, TX 77002(713) 376-3459(832) 369-7665 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 27, 2024, May 15, 2017 (2 updates tracked since 2017).

About Dr. Tony Ai Pham M.d. NPPES

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

DR. TONY AI PHAM M.D. (NPI 1245419225) is an individual psychiatry provider in Houston, Texas, licensed in Texas (M5883) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (1993).

NPPES Registry Identity

NPI1245419225
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. TONY AI PHAMCredential: M.D.
Location Address1315 ST JOSEPH PKWY 1307Houston, TX 77002-8236
Mailing Address2247 Goldsmith StHouston, TX 77030-1118 · (713) 376-3459 · Fax (832) 369-7665
Phone(713) 376-3459
Fax(832) 369-7665
Sole ProprietorYes
Medical School CMSBaylor College Of MedicineGraduated 1993
Enumeration DateOctober 26, 2007
Last NPPES UpdateSeptember 27, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2024
✔ NPI 1245419225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in TX · M5883
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedPsychiatry & Neurology · Addiction PsychiatryTaxonomy 2084P0802X · License M5883 (TX)
1315 ST JOSEPH PKWY 1307, Houston, TX 77002
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Other Names 1

Former Name (1)Dr. Ai Chi Pham M.d.

Other Identifiers 2

Medicaid173990604TX
Medicaid173990601TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Providence Health Plan, WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tony Ai Pham M.d. 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 ID6507801024
PECOS Enrollment IDI20050624000870
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.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
243 services74 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
229 services71 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
97 services45 patients
Psychotherapy with evaluation and management visit, 45 minutes 90836
Psychotherapy with evaluation and management is a 45-minute session where a healthcare provider discusses your mental and emotional health. They assess your current state, manage any issues, and help you develop coping strategies. This service aims to improve your overall well-being.
63 services22 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
48 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77002 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
$176.98 typical visit price
range $58.24 – $176.98
Typical copayment $44.24 (range $14.56 – $44.24)
Most-billed visit code 99205
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
Most-billed visit code 99213
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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
55%2,375 patients1/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 83% · 478 patients
Patients tobacco: 69% · 478 patients
24%113 patients1/55-star benchmark: 98%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 91 patients
5%91 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Tony Pham's NPI number?

The NPI number for Tony Pham is 1245419225. It was assigned to this individual provider in the NPPES registry on October 26, 2007. The provider is also known as Dr. Ai Chi Pham M.D..

Where is Tony Pham located?

Tony Pham practices at 1315 St Joseph Pkwy 1307, Houston, TX 77002. The listed phone number is (713) 376-3459.

What is Tony Pham's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Tony Pham enrolled in Medicare?

Yes. Tony 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.

What insurance does Tony Pham accept?

Health plans from Blue Cross and Blue Shield of Texas, Providence Health Plan and WellPoint list Tony Pham 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 Tony Pham was last updated on September 27, 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.