DR. KENNETH PHAN M.D.
NPI 1336250836
Obstetrics & Gynecology in San Jose, CA

Q: What is Kenneth Phan's NPI number?

The NPI number for Kenneth Phan is 1336250836. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Q: What is Kenneth Phan's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Phan was last updated on April 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since August 31, 2006PECOS Enrolled

150 N JACKSON AVE, SUITE 209, SAN JOSE, CA 95116(408) 929-2680(408) 929-4635 Get Directions Write a Review

NPPES record last updated: April 29, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Kenneth Phan M.d. NPPES

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

DR. KENNETH PHAN M.D. (NPI 1336250836) is an individual obstetrics & gynecology provider in San Jose, California, licensed in California (A77173) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (1998).

NPPES Registry Identity

NPI1336250836

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameDR. KENNETH PHANCredential: M.D.

Location Address150 N JACKSON AVE, SUITE 209San Jose, CA 95116-1908

Mailing Address150 N Jackson Ave, Suite 209San Jose, CA 95116-1908 · (408) 929-2680 · Fax (408) 929-4635

Phone(408) 929-2680

Fax(408) 929-4635

Sole ProprietorYes

Medical School CMSTufts University School Of MedicineGraduated 1998

Enumeration DateAugust 31, 2006

Last NPPES UpdateApril 29, 2013

✔ NPI 1336250836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in CA · A77173

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

150 N JACKSON AVE, San Jose, CA 95116

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Other Identifiers 3

Medicare UPINH56587CA

Medicare ID-Type Unspecified00A771730CA

Medicaid00A771730CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth Phan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426057464

PECOS Enrollment IDI20061220000342

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 3

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.

18 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95116 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

$156.67 typical visit price

range $70.37 – $206.04

Typical copayment $39.16 (range $17.59 – $51.51)

Most-billed visit code 99204

Established Patient

$86.56 typical visit price

range $23.96 – $169.60

Typical copayment $21.64 (range $5.99 – $42.40)

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.

Other Providers at the Same Location NPPES 13

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

DR. HARSHA VITTAL MD

Internal Medicine (Gastroenterology)

150 N JACKSON AVE, SUITE 107
SAN JOSE, CA 95116

Santa Clara County (408) 926-2182

DON ALLEN STEVENSON DDS INC.

Dentist (General Practice)

150 N JACKSON AVE, SUITE 204
SAN JOSE, CA 95116

Santa Clara County (408) 259-4515

DR. RALPH STEPHEN ZOTOVICH DDS

Dentist (Pediatric Dentistry)

150 N JACKSON AVE, SUITE 110
SAN JOSE, CA 95116

Santa Clara County (408) 259-1133

MICHAEL ORAN BAMBICO D.D.S.

Dentist

150 N JACKSON AVE, SUITE # 103
SAN JOSE, CA 95116

Santa Clara County (408) 259-1004

DR. DENNIS TERRAK CALVERT D.D.S.

Dentist (Periodontics)

150 N JACKSON AVE, SUITE 210
SAN JOSE, CA 95116

Santa Clara County (408) 272-7600

DENNIS WADE CALVERT D.D.S.

Dentist (Periodontics)

150 N JACKSON AVE, SUITE 210
SAN JOSE, CA 95116

Santa Clara County (408) 272-7600

SIKKA DENTAL CORP

Dentist

150 N JACKSON AVE, STE 203
SAN JOSE, CA 95116

Santa Clara County (408) 259-1280

SAN SAN MYINT MD

Internal Medicine

150 N JACKSON AVE, # 100
SAN JOSE, CA 95116

Santa Clara County (408) 621-1536

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 Kenneth Phan's NPI number?

The NPI number for Kenneth Phan is 1336250836. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Kenneth Phan located?

Kenneth Phan practices at 150 N Jackson Ave Suite 209, San Jose, CA 95116. The listed phone number is (408) 929-2680.

What is Kenneth Phan's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kenneth Phan enrolled in Medicare?

Yes. Kenneth Phan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Phan was last updated on April 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.