DR. PHONG CAM TA D.D.S.
NPI 1861646747
Dentist - Dentist Anesthesiologist in New York, NY

Active since November 05, 2008PECOS Enrolled
410 W 53RD ST, APT 126, NEW YORK, NY 10019(215) 527-8768 Get Directions Write a Review

NPPES record last updated: June 16, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2016, Feb 11, 2016 (2 updates tracked since 2016).

About Dr. Phong Cam Ta D.d.s. NPPES

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

DR. PHONG CAM TA D.D.S. (NPI 1861646747) is an individual dentist anesthesiologist in New York, New York, licensed in New York (054360) and active in the NPI registry since November 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861646747
Entity TypeIndividualMale
Primary Taxonomy1223D0004X
Provider Legal NameDR. PHONG CAM TACredential: D.D.S.
Location Address410 W 53RD ST, APT 126New York, NY 10019-5622
Mailing Address410 W 53rd St, Apt 126New York, NY 10019-5693 · (215) 527-8768
Sole ProprietorYes
Enumeration DateNovember 5, 2008
Last NPPES UpdateJune 16, 20162 updates tracked since enumeration
NPI 1861646747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Dentist AnesthesiologistDental Providers
Taxonomy Code1223D0004X
License Licensed in NY · 054360
Definition

A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.

Also ListedDentistTaxonomy 122300000X · License P65701 (NY)
410 W 53RD ST, New York, NY 10019

Other Identifiers 1

Medicaid03203894NY

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Phong Cam Ta D.d.s. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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

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

Contractor
410 W 53RD ST, #707
NEW YORK, NY 10019

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 Phong Ta's NPI number?

The NPI number for Phong Ta is 1861646747. It was assigned to this individual provider in the NPPES registry on November 5, 2008.

Where is Phong Ta located?

Phong Ta practices at 410 W 53rd St Apt 126, New York, NY 10019. The listed phone number is (215) 527-8768.

What is Phong Ta's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dentist Anesthesiologist, with taxonomy code 1223D0004X.

Is Phong Ta enrolled in Medicare?

Yes. Phong Ta is registered in the Medicare PECOS enrollment system.

What insurance does Phong Ta accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Phong Ta 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 Phong Ta was last updated on June 16, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.