SANDY PHAN
NPI 1497696504
Nurse Practitioner - Acute Care in Philadelphia, PA

Q: What is Sandy Phan's NPI number?

The NPI number for Sandy Phan is 1497696504. It was assigned to this individual provider in the NPPES registry on April 2, 2026.

Q: What is Sandy Phan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Sandy Phan was last updated on April 2, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 02, 2026PECOS Enrolled

3400 SPRUCE ST, PHILADELPHIA, PA 19104(267) 230-6443 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Sandy Phan NPPES

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

SANDY PHAN (NPI 1497696504) is an individual acute care provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP034751) and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS, maintains a secondary practice location in Philadelphia, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1497696504

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameSANDY PHAN

Location Address3400 SPRUCE STPhiladelphia, PA 19104-4238

Mailing Address731 Longshore AvePhiladelphia, PA 19111-4324

Phone(267) 230-6443

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 2, 2026

NPPES CertifiedApril 2, 2026

✔ NPI 1497696504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in PA · SP034751

3400 SPRUCE ST, Philadelphia, PA 19104

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Secondary Practice Location 1

Location 13400 Civic Center BlvdPhiladelphia, PA 19104-5127 · Phone (267) 230-6443

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID4688142961

PECOS Enrollment IDI20260505002832

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

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