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LEE THI PHAN PA
NPI 1790458552
Physician Assistant - Surgical in Henderson, NV

Active since July 28, 2021PECOS Enrolled
76.2/100
CMS Quality Rating
2839 SAINT ROSE PKWY STE 100, HENDERSON, NV 89052(028) 378-9887(702) 837-8988 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 24, 2026, Sep 16, 2021, Jul 28, 2021 (3 updates tracked since 2021).

About Lee Thi Phan Pa NPPES

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

LEE THI PHAN PA (NPI 1790458552) is an individual surgical provider in Henderson, Nevada, licensed in Nevada (PA2950) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790458552
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameLEE THI PHANCredential: PA
Location Address2839 SAINT ROSE PKWY STE 100Henderson, NV 89052-4849
Mailing Address2839 Saint Rose Pkwy Ste 100Henderson, NV 89052-4849 · (702) 837-8988 · Fax (702) 990-5269
Phone(028) 378-9887
Fax(702) 837-8988
Sole ProprietorNo
Enumeration DateJuly 28, 2021
Last NPPES UpdateMarch 24, 20263 updates tracked since enumeration
NPPES CertifiedMarch 24, 2026
✔ NPI 1790458552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NV · PA2950
2839 SAINT ROSE PKWY STE 100, Henderson, NV 89052
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lee Thi Phan Pa 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 Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.33
Promoting Interoperability100
Improvement Activities40
Cost51.32

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CURT SAMLASKA LTD ACADEMIC DERMATOLOGY OF NEVADA
Dermatology
2839 SAINT ROSE PKWY STE 100
HENDERSON, NV 89052
Clark County (702) 837-8988
CURT SAMLASKA LTD ACADEMIC DERMATOLOGY OF NEVADA
Dermatology
2839 SAINT ROSE PKWY STE 100
HENDERSON, NV 89052
Clark County (702) 837-8988
MR. ANDREW S RACKHAM PA
Physician Assistant (Surgical)
2839 SAINT ROSE PKWY STE 100
HENDERSON, NV 89052
Clark County (702) 837-8988

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 Lee Phan's NPI number?

The NPI number for Lee Phan is 1790458552. It was assigned to this individual provider in the NPPES registry on July 28, 2021.

Where is Lee Phan located?

Lee Phan practices at 2839 Saint Rose Pkwy Ste 100, Henderson, NV 89052. The listed phone number is (028) 378-9887.

What is Lee Phan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Lee Phan enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Lee Phan was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.