ANDREW TJ PHAN
NPI 1720693054
Nurse Anesthetist, Certified Registered in San Leandro, CA

Active since September 14, 2020Accepts Medicare Assignment
2500 MERCED ST, SAN LEANDRO, CA 94577(510) 454-2069 Get Directions Write a Review

NPPES record last updated: April 6, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 6, 2025, Jan 26, 2022, Mar 8, 2021 and 1 more (4 updates tracked since 2020).

About Andrew Tj Phan NPPES

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

ANDREW TJ PHAN (NPI 1720693054) is an individual nurse anesthetist, certified registered in San Leandro, California, licensed in California (95001468) and active in the NPI registry since September 2020. He is a graduate of Other (2020).

NPPES Registry Identity

NPI1720693054
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameANDREW TJ PHAN
Location Address2500 MERCED STSan Leandro, CA 94577-4201
Mailing Address2500 Merced StSan Leandro, CA 94577-4201
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 14, 2020
Last NPPES UpdateApril 6, 20254 updates tracked since enumeration
NPPES CertifiedApril 6, 2025
NPI 1720693054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in CA · 95001468
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered NurseTaxonomy 163W00000X · License 95035493 (CA)
2500 MERCED ST, San Leandro, CA 94577

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Andrew Tj Phan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547676744
PECOS Enrollment IDI20210315000442

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94577 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
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.

Emergency Medicine
2500 MERCED ST
SAN LEANDRO, CA 94577
Dietitian, Registered
2500 MERCED ST, B3-FOOD AND NUTRITION SERVICES
SAN LEANDRO, CA 94577
Pharmacist
2500 MERCED ST
SAN LEANDRO, CA 94577
Internal Medicine (Pulmonary Disease)
2500 MERCED ST
SAN LEANDRO, CA 94577
Obstetrics & Gynecology
2500 MERCED ST
SAN LEANDRO, CA 94577
Internal Medicine
2500 MERCED ST
SAN LEANDRO, CA 94577
Internal Medicine
2500 MERCED ST
SAN LEANDRO, CA 94577
Hospitalist
2500 MERCED ST
SAN LEANDRO, CA 94577

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 Andrew Phan's NPI number?

The NPI number for Andrew Phan is 1720693054. It was assigned to this individual provider in the NPPES registry on September 14, 2020.

Where is Andrew Phan located?

Andrew Phan practices at 2500 Merced St, San Leandro, CA 94577. The listed phone number is (510) 454-2069.

What is Andrew Phan's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Andrew Phan enrolled in Medicare?

Yes. Andrew Phan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Andrew Phan was last updated on April 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.