TOM PHAM MD
NPI 1366939795
Pediatrics - Pediatric Emergency Medicine in New Berlin, WI

Q: What is Tom Pham's NPI number?

The NPI number for Tom Pham is 1366939795. It was assigned to this individual provider in the NPPES registry on April 20, 2018.

Q: What is Tom Pham's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Tom Pham was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 20, 2018PECOS Enrolled

74.59/100

CMS Quality Rating

4855 S MOORLAND RD FL 3, NEW BERLIN, WI 53151(262) 432-7599(262) 432-7694 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 19, 2022, Aug 3, 2021, Apr 20, 2018 (3 updates tracked since 2018).

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About Tom Pham Md NPPES

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

TOM PHAM MD (NPI 1366939795) is an individual pediatric emergency medicine provider in New Berlin, Wisconsin, licensed in Texas (T7331) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366939795

Entity TypeIndividualMale

Primary Taxonomy2080P0204X

Provider Legal NameTOM PHAMCredential: MD

Location Address4855 S MOORLAND RD FL 3New Berlin, WI 53151-7494

Mailing AddressPo Box 845347Dallas, TX 75284-5347 · (214) 476-8559

Phone(262) 432-7599

Fax(262) 432-7694

Sole ProprietorNo

Enumeration DateApril 20, 2018

Last NPPES UpdateDecember 19, 20223 updates tracked since enumeration

NPPES CertifiedDecember 19, 2022

✔ NPI 1366939795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in TX · T7331

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License 75525 (WI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4855 S MOORLAND RD FL 3, New Berlin, WI 53151

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Other Identifiers 1

Medicaid1366939795WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 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.

74.59/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

56.12

Promoting Interoperability

100

Improvement Activities

Cost

59.2

Other Providers at the Same Location NPPES 17

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

DR. CARL J PELUSO M.D.

Pediatrics