SEAN PHAM M.D.
NPI 1891054938
Family Medicine in Alexandria, VA

Q: What is Sean Pham's NPI number?

The NPI number for Sean Pham is 1891054938. It was assigned to this individual provider in the NPPES registry on May 9, 2012.

Q: What is Sean Pham's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Pham was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 09, 2012PECOS EnrolledAccepts Medicare Assignment

93.51/100

CMS Quality Rating

6355 WALKER LN STE 500, ALEXANDRIA, VA 22310(703) 797-6970(703) 922-3479 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 4, 2021, Oct 17, 2020 (2 updates tracked since 2020).

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About Sean Pham M.d. NPPES

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

SEAN PHAM M.D. (NPI 1891054938) is an individual family medicine provider in Alexandria, Virginia, licensed in Virginia (0101258473) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Inova Alexandria Hospital, and maintains a secondary practice location in Roanoke.

NPPES Registry Identity

NPI1891054938

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSEAN PHAMCredential: M.D.

Location Address6355 WALKER LN STE 500Alexandria, VA 22310-3251

Mailing Address6355 Walker Ln Ste 500Alexandria, VA 22310-3251 · (703) 797-6970 · Fax (703) 922-3479

Phone(703) 797-6970

Fax(703) 922-3479

Sole ProprietorYes

Medical School CMSVirginia Commonwealth University, School Of MedicineGraduated 2007

Enumeration DateMay 9, 2012

Last NPPES UpdateOctober 4, 20212 updates tracked since enumeration

NPPES CertifiedOctober 4, 2021

✔ NPI 1891054938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in VA · 0101258473

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

6355 WALKER LN STE 500, Alexandria, VA 22310

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Secondary Practice Location 1

Location 11314 Peters Creek Rd NWRoanoke, VA 24017-2500 · Phone (800) 950-3149

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sean Pham M.d. 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 ID4789818816

PECOS Enrollment IDI20151229000592, I20160125001754

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 Reassignments

Medicare enrollment records show Sean Pham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Inova Health Care Services

7.4 mi

Medical Oncology

8081 INNOVATION PARK DR
Fairfax, VA 22031

Reassigned Medicare billing, District of Columbia and Virginia enrollments
258 clinicians in this Medicare group

NPI 1275097123 (703) 289-2454

Inova Physician Partners, LLC

17 mi

Family Medicine

3914 CENTREVILLE RD, SUITE 250
Chantilly, VA 20151

Reassigned Medicare billing, District of Columbia and Virginia enrollments
379 clinicians in this Medicare group

NPI 1215264916 (703) 321-2609

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

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

332 services203 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

135 services135 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

99 services13 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

89 services71 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

63 services45 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

44 services44 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

34 services34 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

34 services34 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

20 services20 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

20 services20 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

18 services16 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Inova Alexandria Hospital

Acute Care Hospitals · Alexandria, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490040

Location4320 Seminary RdAlexandria, VA 22304 · Alexandria City County

Emergency services Birthing friendly

Inova Mount Vernon Hospital

Acute Care Hospitals · Alexandria, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490122

Location2501 Parkers LaneAlexandria, VA 22306 · Fairfax County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22310 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

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.

93.51/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.02

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers24 claims48 services$5.52 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers14 claims14 services$11.05 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

MANPREET SINGH MD

Family Medicine