TIEN T PHAM APN, CNP
NPI 1912473273
Nurse Practitioner in Peoria, IL

Q: What is Tien Pham's NPI number?

The NPI number for Tien Pham is 1912473273. It was assigned to this individual provider in the NPPES registry on October 15, 2018.

Q: What is Tien Pham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Tien Pham was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since October 15, 2018PECOS EnrolledAccepts Medicare Assignment

5405 N KNOXVILLE AVE, PEORIA, IL 61614(309) 589-2050(309) 692-4730 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 7, 2025, Oct 15, 2018 (2 updates tracked since 2018).

On this page

About Tien T Pham Apn, Cnp NPPES

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

TIEN T PHAM APN, CNP (NPI 1912473273) is an individual nurse practitioner in Peoria, Illinois, licensed in Illinois (209017737) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS, is affiliated with Graham Hospital Association, and maintains a secondary practice location in Peoria.

NPPES Registry Identity

NPI1912473273

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTIEN T PHAMCredential: APN, CNP

Location Address5405 N KNOXVILLE AVEPeoria, IL 61614-5016

Mailing Address5405 N Knoxville AvePeoria, IL 61614-5016 · (309) 589-2050 · Fax (309) 692-4730

Phone(309) 589-2050

Fax(309) 692-4730

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 15, 2018

Last NPPES UpdateMay 7, 20252 updates tracked since enumeration

NPPES CertifiedMay 7, 2025

✔ NPI 1912473273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209017737

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

5405 N KNOXVILLE AVE, Peoria, IL 61614

Open in Google Maps ↗

Secondary Practice Location 1

Location 11127 W Glen AvePeoria, IL 61614-4865 · Phone (309) 916-9100 · Fax (309) 916-9099

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

Tien T Pham Apn, Cnp 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 ID3476807264

PECOS Enrollment IDI20181114001102

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 Tien Pham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Saint Francis Medical Center

3.3 mi

Family Medicine

200 E PENNSYLVANIA AVE
Peoria, IL 61603

Reassigned Medicare billing, Illinois enrollment
157 clinicians in this Medicare group

NPI 1306890033 (800) 589-6070

Osf Multi-Specialty Group

4.8 mi

Internal Medicine

8600 N STATE ROUTE 91
Peoria, IL 61615

Reassigned Medicare billing, Illinois enrollment
2,944 clinicians in this Medicare group

NPI 1922445527 (309) 683-5050

St. Mary Medical Center

43 mi

Family Medicine

100 N MONROE ST
Abingdon, IL 61410

Reassigned Medicare billing, Illinois enrollment
101 clinicians in this Medicare group

NPI 1861109647 (309) 462-2343

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 5

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.

290 services264 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.

176 services164 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

118 services115 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.

16 services16 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

15 services15 patients

Hospital Affiliations CMS Care Compare 4

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

Graham Hospital Association

Acute Care Hospitals · Canton, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140001

Location210 West Walnut StreetCanton, IL 61520 · Fulton County

Emergency services Birthing friendly

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140064

Location3333 North SeminaryGalesburg, IL 61401 · Knox County

Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Osf Saint Elizabeth Mdl Ctr

Acute Care Hospitals · Ottawa, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140110

Location1100 E Norris DriveOttawa, IL 61350 · La Salle County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

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.

CHRISTINE C PERKS MD

Internal Medicine (Cardiovascular Disease)