LAURA T PHAN MD
NPI 1538366984
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Saratoga, CA

NPI Status: Active since June 29, 2007

Contact Information

20398 BLAUER DR
SARATOGA, CA
ZIP 95070
Phone: (408) 502-5000
Fax: (408) 502-5505

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 20
Ophthalmology
Ophthalmic Plastic and Reconstructive Su...
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About LAURA PHAN

This page provides the complete NPI Profile along with additional information for Laura Phan, a provider established in Saratoga, California with a medical specialization in Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery and more than 20 years of experience. She graduated from Virginia Commonwealth University, School Of Medicine in 2006. The healthcare provider is registered in the NPI registry with number 1538366984 assigned on June 2007. The practitioner's primary taxonomy code is 207WX0200X with license number A126463 (CA). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI: 1538366984
Provider Name: LAURA T PHAN MD
Gender: Female
Entity Type: Individual
Location Address: 20398 BLAUER DR SARATOGA, CA 95070
Location Phone: (408) 502-5000
Location Fax: (408) 502-5505
Mailing Address: 20398 BLAUER DR SARATOGA, CA 95070
Mailing Phone: (408) 502-5000
Mailing Fax: (408) 502-5505
Medical School Name: VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduation Year: 2006
Is Sole Proprietor?: Yes
Enumeration Date: 06-29-2007
Last Update Date: 11-18-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Ophthalmology Ophthalmic Plastic and Reconstructive Surgery
Taxonomy Code: 207WX0200X
Type: Allopathic & Osteopathic Physicians
License No.: A126463
License State: CA
Taxonomy Description: A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology	A126463 (CA)
2	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology	D72821 (MD)
3	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology	4301097337 (MI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
047445200	MEDICAID (05)	MD

Medicare Participation & PECOS Enrollment Status

Laura Phan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Laura Phan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 4880881705
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20131025000421
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Closure of tear duct opening using plug
Established patient complete exam of visual system
Established patient office or other outpatient visit, 30-39 minutes
Established patient problem focused exam of visual system
Exam of visual field with intermediate testing
Insertion of probe into nasal tear duct
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 45-59 minutes
Photography of content of eyes
Reconstruction of eyelid margin
Removal of growth of eyelid
Repair of tendon of upper eyelid

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $39.16 for a new patient copayment and $21.64 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 95070 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $156.67
Minimum New Patient Price $70.37
Maximum New Patient Price $206.04

Average New Patient Copayment $39.16
Minimum New Patient Copayment $17.59
Maximum New Patient Copayment $51.51

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $86.56
Minimum Established Patient Price $23.96
Maximum Established Patient Price $169.6

Average Established Patient Copayment $21.64
Minimum Established Patient Copayment $5.99
Maximum Established Patient Copayment $42.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
CDC Training on CDC's Guideline for Prescribing Opioids for Chronic Pain	Yes	N/A
Completion of all the modules of the Centers for Disease Control and Prevention (CDC) course “Applying CDC’s Guideline for Prescribing Opioids” that reviews the 2016 “Guideline for Prescribing Opioids for Chronic Pain.” Note: This activity may be selected once every 4 years, to avoid duplicative information given that some of the modules may change on a year by year basis but over 4 years there would be a reasonable expectation for the set of modules to have undergone substantive change, for the improvement activities performance category score.
Completion of CDC Training on Antibiotic Stewardship	Yes	N/A
Completion of all modules of the Centers for Disease Control and Prevention antibiotic stewardship course. Note: This activity may be selected once every 4 years, to avoid duplicative information given that some of the modules may change on a year by year basis but over 4 years there would be a reasonable expectation for the set of modules to have undergone substantive change, for the improvement activities performance category score.
Engagement of Patients, Family, and Caregivers in Developing a Plan of Care	Yes	N/A
Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology.
Preventive Care and Screening: Screening for Depression and Follow-Up Plan	72%	356
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Use of High-Risk Medications in the Elderly	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	254
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	5	3	8	3	6	6	9	8	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	5	6	8	6	6	12	9	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 6 + 8 + 6 + 6 + 1 + 2 + 9 + 1 + 6 + 24 = 76
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 76 = 4									4

The NPI number 1538366984 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 5 providers are registered at the same or nearby location.

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Clinic/Center

(Ambulatory Surgical)