DR. DONALD MINH PHAM M.D.
NPI 1437319993
Internal Medicine - Gastroenterology in Lawrenceville, GA

Q: What is Donald Pham's NPI number?

The NPI number for Donald Pham is 1437319993. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Q: What is Donald Pham's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Donald Pham was last updated on October 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 June 09, 2008PECOS EnrolledAccepts Medicare Assignment

79.88/100

CMS Quality Rating

301 PHILIP BLVD STE A, LAWRENCEVILLE, GA 30046(770) 822-5560(770) 822-4989 Get Directions Write a Review

NPPES record last updated: October 3, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2018, Aug 17, 2018 (2 updates tracked since 2018).

On this page

About Dr. Donald Minh Pham M.d. NPPES

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

DR. DONALD MINH PHAM M.D. (NPI 1437319993) is an individual gastroenterology provider in Lawrenceville, Georgia, licensed in Georgia (071551) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Emory University School Of Medicine (2008).

NPPES Registry Identity

NPI1437319993

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. DONALD MINH PHAMCredential: M.D.

Location Address301 PHILIP BLVD STE ALawrenceville, GA 30046

Mailing Address1001 Summit Blvd Ste 200Brookhaven, GA 30319-6410 · (770) 989-1634 · Fax (678) 358-1759

Phone(770) 822-5560

Fax(770) 822-4989

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2008

Enumeration DateJune 9, 2008

Last NPPES UpdateOctober 3, 20182 updates tracked since enumeration

✔ NPI 1437319993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in GA · 071551

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

301 PHILIP BLVD STE A, Lawrenceville, GA 30046

Open in Google Maps ↗

Other Identifiers 1

Medicaid003146015GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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. Donald Minh 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 ID3476777079

PECOS Enrollment IDI20140623001807

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 8

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 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.

99 services78 patients

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.

57 services51 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

35 services35 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

28 services28 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.

28 services28 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

18 services18 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110087

Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County

Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Piedmont Eastside Medical Center

Acute Care Hospitals · Snellville, GA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number110192

Location1700 Medical WaySnellville, GA 30078 · Gwinnett County

Emergency services Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110252

Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

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.

79.88/100

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

Scored as part of a group practice

Quality

56.48

Promoting Interoperability

Improvement Activities

Cost

78.12

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

98%107 patients5/55-star benchmark: 85%

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.

100%306 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%301 patients4/55-star benchmark: 100%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

92%494 patients5/55-star benchmark: 88%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

98%64 patients4/55-star benchmark: 100%

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% · 53 patients

2%53 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

2 suppliers19 claims8,760 services$0.27 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

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

JACQUELINE ELIZABETH TIZOL-URENA PAC

Physician Assistant