TONY C PHAM – Family Medicine Physician, NPI 1235879081

TONY C PHAM is a healthcare provider. based in Pine bluff, Arkansas. specializing in FAMILY PRACTICE. They hold a License No. MD-55511 (IA). The NPI Number for TONY C PHAM is 1235879081

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
TONY C PHAM
NPI
1235879081
Phone
(870) 541-6000
Address
1601 W 40th Ave Ste 100
Enumeration Date
30 March 2022
Last Update Date
3 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6413223121
Graduation Year
2021 (5 years ago)
PAC ID
0648768622
Group Practice PAC ID
0547154940
Professional Enrollment ID
I20251022000286
Address ID
IA508411683CO603XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

1,499 FAMILY PRACTICE in AR

Provider Addresses for TONY C PHAM

  • 1601 W 40th Ave Ste 100

    Pine Bluff, AR 716036069

    Phone: (870) 541-6000

    Fax: (870) 541-6009

    Type: Location

  • 1601 W 40TH AVE STE 100

    PINE BLUFF, AR 716036069

    Phone: (870) 541-6000

    Fax: (870) 541-6009

    Type: Mailing

  • 601 ROSARY DR

    CORNING, IA 508411683

    Phone: (641) 322-5245

    Fax: (641) 322-4687

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251022000286IFamily PracticeIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 71603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547154940View full group profile

Reviews

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Frequently asked questions

Is TONY C PHAM listed with a National Provider Identifier?
Yes — TONY C PHAM has NPI 1235879081 on file in the registry.
Active or inactive — what applies to TONY C PHAM?
You should see TONY C PHAM as active in CMS-hosted NPPES data.
What area of care is associated with TONY C PHAM?
TONY C PHAM's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Arkansas is TONY C PHAM registered?
Use Pine Bluff, Arkansas as the headline location for TONY C PHAM here.
When was this NPI issued?
Enumeration for TONY C PHAM is noted as March 30, 2022 where the registry provides it.

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