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ASIAN VILLAGE MEDICAL CLINIC PC
NPI 1548436892
Clinic/Center in Chicago, IL

Active since May 07, 2008CLIA 14D0997375 · Waiver
5129 N BROADWAY ST, SUITE E, CHICAGO, IL 60640(774) 275-4250(773) 275-4263 Get Directions Write a Review

NPPES record last updated: September 30, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Asian Village Medical Clinic Pc NPPES

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

ASIAN VILLAGE MEDICAL CLINIC PC (NPI 1548436892) is a healthcare organization registered as a clinic/center in Chicago, Illinois and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through March 12, 2028 and lists Phuong Tran, President, as its authorized official.

NPPES Registry Identity

NPI1548436892
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameASIAN VILLAGE MEDICAL CLINIC PC
Location Address5129 N BROADWAY ST, SUITE EChicago, IL 60640-3018
Mailing Address5129 N Broadway St, Suite EChicago, IL 60640-3018 · (774) 275-4250 · Fax (773) 275-4263
Phone(774) 275-4250
Fax(773) 275-4263
Organization SubpartNo
Authorized OfficialPhuong TranPresident · (773) 275-4250
Enumeration DateMay 7, 2008
Last NPPES UpdateSeptember 30, 2010
✔ NPI 1548436892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in IL · 036089675
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
5129 N BROADWAY ST, Chicago, IL 60640
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Other Identifiers 2

Medicaid20000433IL
Medicare PINC01332IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Asian Village Medical Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Asian Village Medical Clinic PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Phuong Tran, M.D.
Internal Medicine
NPI 1821137142
5129 NORTH BROADWAY STREET SUITE E
Chicago, IL 60640
(773) 275-4250
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0997375

Asian Village Medical Clinic PC · Chicago, IL
Active · expires Mar 12, 2028
CLIA Number14D0997375
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2026
Certificate Expiration DateMarch 12, 2028
Laboratory DirectorTran L. Phuong
Laboratory Phone(773) 275-4250
Laboratory LocationAsian Village Medical Clinic PC5129 North Broadway Suite E, Chicago, IL 60640
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Asian Village Medical Clinic PC's NPI number?

The NPI number for Asian Village Medical Clinic PC is 1548436892. It was assigned to this organization in the NPPES registry on May 7, 2008.

Where is Asian Village Medical Clinic PC located?

Asian Village Medical Clinic PC is located at 5129 N Broadway St Suite E, Chicago, IL 60640. The listed phone number is (774) 275-4250.

What is Asian Village Medical Clinic PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Asian Village Medical Clinic PC enrolled in Medicare?

Yes. Asian Village Medical Clinic PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Asian Village Medical Clinic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Asian Village Medical Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Asian Village Medical Clinic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0997375) is associated with this NPI, valid through March 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Asian Village Medical Clinic PC accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Asian Village Medical Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Asian Village Medical Clinic PC was last updated on September 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.