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VAN TUY PHAN PA-C
NPI 1912040049
Physician Assistant - Surgical in Lakewood, WA

Active since February 15, 2007PECOS EnrolledAccepts Medicare Assignment
11311 BRIDGEPORT WAY SW STE 100, LAKEWOOD, WA 98499(253) 985-6490(253) 985-6488 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 20, 2021, Jan 13, 2021 (2 updates tracked since 2021).

About Van Tuy Phan Pa-c NPPES

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

VAN TUY PHAN PA-C (NPI 1912040049) is an individual surgical provider in Lakewood, Washington, licensed in Washington (PA10004199) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, is affiliated with St Anthony Hospital, and maintains a secondary practice location in Renton.

NPPES Registry Identity

NPI1912040049
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameVAN TUY PHANCredential: PA-C
Location Address11311 BRIDGEPORT WAY SW STE 100Lakewood, WA 98499-3096
Mailing Address11311 Bridgeport Way Sw Ste 100Lakewood, WA 98499-3096 · (253) 985-6490 · Fax (253) 985-6488
Phone(253) 985-6490
Fax(253) 985-6488
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateFebruary 15, 2007
Last NPPES UpdateJanuary 20, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2021
✔ NPI 1912040049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in WA · PA10004199
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA10004199 (WA)
11311 BRIDGEPORT WAY SW STE 100, Lakewood, WA 98499
Open in Google Maps ↗

Secondary Practice Location 1

Location 14011 Talbot Rd S, Suite 300Renton, WA 98055-5773 · Phone (425) 656-5060 · Fax (425) 656-5047

Other Identifiers 4

Other0262968WA · Lni
OtherG8891647WA · Medicare Ptan
OtherP00918654WA · Medicare Rr
Medicaid1042154WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

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

Van Tuy Phan Pa-c 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 ID5890878193
PECOS Enrollment IDI20080211000060
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.

Hospital Affiliations CMS Care Compare

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

St Anthony Hospital

Acute Care Hospitals · Gig Harbor, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500151
Location11567 Canterwood Boulevard NWGig Harbor, WA 98332 · Pierce County
Emergency services

Other Providers at the Same Location NPPES 5

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

YUKO YAMADA ARNP
Nurse Practitioner (Family)
11311 BRIDGEPORT WAY SW STE 100
LAKEWOOD, WA 98499
Pierce County (253) 985-6490
MICAH LEE PA-C
Physician Assistant
11311 BRIDGEPORT WAY SW STE 100
LAKEWOOD, WA 98499
Pierce County (253) 985-2949
DEEPA GALI MD
Internal Medicine (Rheumatology)
11311 BRIDGEPORT WAY SW STE 100
LAKEWOOD, WA 98499
Pierce County (253) 985-6490
DR. YASMIN BADRUDIN KASSAM
Internal Medicine (Rheumatology)
11311 BRIDGEPORT WAY SW STE 100
LAKEWOOD, WA 98499
Pierce County (253) 985-6490
DR. DANIEL JAEUNG KIM M.D.
Internal Medicine (Rheumatology)
11311 BRIDGEPORT WAY SW STE 100
LAKEWOOD, WA 98499
Pierce County (253) 985-6490

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 Van Phan's NPI number?

The NPI number for Van Phan is 1912040049. It was assigned to this individual provider in the NPPES registry on February 15, 2007.

Where is Van Phan located?

Van Phan practices at 11311 Bridgeport Way SW Ste 100, Lakewood, WA 98499. The listed phone number is (253) 985-6490.

What is Van Phan's specialty?

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

Is Van Phan enrolled in Medicare?

Yes. Van 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.

What insurance does Van Phan accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Van Phan 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.

Is Van Phan affiliated with any hospitals?

According to CMS data, Van Phan is affiliated with St Anthony Hospital.

When was this NPI record last updated?

The NPPES record for Van Phan was last updated on January 20, 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.