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JENNIFER PHAN FNP
NPI 1609372150
Nurse Practitioner - Family in San Diego, CA

Active since April 03, 2018PECOS Enrolled
1452 REED AVE, SAN DIEGO, CA 92109(214) 603-3338 Get Directions Write a Review

NPPES record last updated: May 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 16, 2022, Apr 26, 2022 (2 updates tracked since 2022).

About Jennifer Phan Fnp NPPES

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

JENNIFER PHAN FNP (NPI 1609372150) is an individual family provider in San Diego, California, licensed in California (95008319) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609372150
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJENNIFER PHANCredential: FNP
Location Address1452 REED AVESan Diego, CA 92109-5351
Mailing Address4647 Zion AveSan Diego, CA 92120-2507 · (877) 608-0044
Phone(214) 603-3338
Sole ProprietorNo
Enumeration DateApril 3, 2018
Last NPPES UpdateMay 16, 20222 updates tracked since enumeration
NPPES CertifiedMay 16, 2022
✔ NPI 1609372150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95008319
1452 REED AVE, San Diego, CA 92109
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Phan Fnp 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 Jennifer Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
5.7 mi
Health Maintenance Organization
1288 CAMINO DEL RIO N
San Diego, CA 92108
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1023425972 (877) 608-0044

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 92109 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

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 Jennifer Phan's NPI number?

The NPI number for Jennifer Phan is 1609372150. It was assigned to this individual provider in the NPPES registry on April 3, 2018.

Where is Jennifer Phan located?

Jennifer Phan practices at 1452 Reed Ave, San Diego, CA 92109. The listed phone number is (214) 603-3338.

What is Jennifer Phan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jennifer Phan enrolled in Medicare?

Yes. Jennifer Phan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jennifer Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Phan reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The 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 Jennifer Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Phan was last updated on May 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.