DR. VIVIEN PHUNG MD
NPI 1447754437
Pediatrics in Jackson, MI

Q: What is Vivien Phung's NPI number?

The NPI number for Vivien Phung is 1447754437. It was assigned to this individual provider in the NPPES registry on March 22, 2018.

Q: What is Vivien Phung's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Vivien Phung was last updated on June 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 March 22, 2018PECOS Enrolled

205 N EAST AVE, JACKSON, MI 49201(517) 205-4800 Get Directions Write a Review

NPPES record last updated: June 24, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 24, 2021, Sep 2, 2019, Mar 22, 2018 (3 updates tracked since 2018).

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About Dr. Vivien Phung Md NPPES

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

DR. VIVIEN PHUNG MD (NPI 1447754437) is an individual pediatrics provider in Jackson, Michigan, licensed in Michigan (4301504829) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Orange.

NPPES Registry Identity

NPI1447754437

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. VIVIEN PHUNGCredential: MD

Location Address205 N EAST AVEJackson, MI 49201-1753

Mailing Address1 Ford Pl Ste 2eDetroit, MI 48202-3450 · (313) 874-4806

Phone(517) 205-4800

Sole ProprietorNo

Enumeration DateMarch 22, 2018

Last NPPES UpdateJune 24, 20213 updates tracked since enumeration

NPPES CertifiedJune 24, 2021

✔ NPI 1447754437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in MI · 4301504829✔ Licensed in CA · 164816

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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

205 N EAST AVE, Jackson, MI 49201

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Secondary Practice Location 1

Location 1505 S Main St Ste 525Orange, CA 92868-4553 · Phone (714) 456-5631 · Fax (714) 285-0389

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Vivien Phung 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 Vivien Phung reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wa Foote Memorial Hospital Inc.

0.4 mi

Pediatrics

760 W FRANKLIN ST
Jackson, MI 49201

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: W.A. Foote Memorial Hospital
62 clinicians in this Medicare group

NPI 1265806343 (517) 205-2700

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49201 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

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.

SAMANTHA RENE DANEK PA-C

Physician Assistant