Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JESSICA PHAM
NPI 1417816505
Anesthesiologist Assistant in Waco, TX

Q: What is Jessica Pham's NPI number?

The NPI number for Jessica Pham is 1417816505. It was assigned to this individual provider in the NPPES registry on January 15, 2026.

Q: What is Jessica Pham's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Pham was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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 January 15, 2026

100 HILLCREST MEDICAL BLVD, WACO, TX 76712(254) 202-2000(254) 202-5849 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 27, 2026, Apr 24, 2026, Jan 15, 2026 (3 updates tracked since 2026).

On this page

About Jessica Pham NPPES

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

JESSICA PHAM (NPI 1417816505) is an individual anesthesiologist assistant in Waco, Texas, licensed in Texas (789790902) and active in the NPI registry since January 2026. She maintains a secondary practice location in Washington and is a graduate of Other (2026).

NPPES Registry Identity

NPI1417816505

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameJESSICA PHAM

Location Address100 HILLCREST MEDICAL BLVDWaco, TX 76712-8897

Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (800) 994-0371 · Fax (254) 215-9722

Phone(254) 202-2000

Fax(254) 202-5849

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateJanuary 15, 2026

Last NPPES UpdateAugust 27, 20263 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

✔ NPI 1417816505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in TX · 789790902

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

100 HILLCREST MEDICAL BLVD, Waco, TX 76712

Open in Google Maps ↗

Secondary Practice Location 1

Location 11 DuPont Cir NW Ste 600Washington, DC 20036-1106 · Phone (202) 758-2502

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID8426525098

PECOS Enrollment IDI20260430004330

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.

ISAAC LILL

Internal Medicine