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

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: October 25, 2026.

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

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
Open in Google Maps ↗

Other Identifiers 1

Medicaid1366939795WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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 Billing Reassignment

Medicare enrollment records show Tom Pham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Texas Southwestern Medical Center At Dallas
829 mi
Obstetrics & Gynecology
7800 PRESTON ROAD, SUITE 300
Plano, TX 75024
  • Reassigned Medicare billing, Texas enrollment
  • 5,299 clinicians in this Medicare group
NPI 1518984988 (214) 645-0624

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
Quality56.12
Promoting Interoperability100
Improvement Activities40
Cost59.2

Other Providers at the Same Location NPPES 20

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

DR. CARL J PELUSO M.D.
Pediatrics
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
MS. ANDREA FOX APRN
Nurse Practitioner (Pediatrics)
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
KATHERINE CIMINELLI WALLER APNP
Nurse Practitioner (Pediatrics)
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
VIANE FAILY MD
Pediatrics
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
SHANNON CHERIAN MD
Pediatrics
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
KELSEY AILEEN BJORNSON APRN
Nurse Practitioner (Pediatrics)
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
MRS. JULIA FISCHER ROMEISER M.D.
Pediatrics
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599
JILL M CZAJKOWSKI MD
Pediatrics
4855 S MOORLAND RD FL 3
NEW BERLIN, WI 53151
Waukesha County (262) 432-7599

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 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.

Where is Tom Pham located?

Tom Pham practices at 4855 S Moorland Rd Fl 3, New Berlin, WI 53151. The listed phone number is (262) 432-7599.

What is Tom Pham's specialty?

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

Is Tom Pham enrolled in Medicare?

Yes. Tom Pham is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tom Pham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tom Pham reassigns Medicare benefits to University Of Texas Southwestern Medical Center At Dallas (Plano, TX). The 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 Tom Pham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tom Pham accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Tom 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 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.