DR. NICOLE ANH PHAM (O. D.) – Optometrist, NPI 1235119108

DR. NICOLE ANH PHAM (O. D.) is a healthcare provider. based in San jose, California. specializing in OPTOMETRY. They hold the professional credentials O. D.. They hold a License No. 10549T (CA). The NPI Number for DR. NICOLE ANH PHAM (O. D.) is 1235119108

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICOLE ANH PHAM (O. D.)
NPI
1235119108
Phone
(408) 223-6853
Address
5366 BEAUMONT CANYON DR
Enumeration Date
18 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
408263204015
Graduation Year
1995 (31 years ago)
PAC ID
6709040041
Group Practice PAC ID
6406013143
Professional Enrollment ID
I20120618000034
Address ID
CA950355543MI1301XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,935 OPTOMETRY in CA

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Provider Addresses for DR. NICOLE ANH PHAM (O. D.)

  • 5366, Beaumont Canyon Drive, Silver Creek, San Jose, Santa Clara County, California, 95138, United States

    SAN JOSE, CA 951382432

    Phone: (408) 223-6853

    Fax: (408) 223-6853

    Type: Mailing

  • 1301, East Calaveras Boulevard, Milpitas, Santa Clara County, California, 95035, United States

    MILPITAS, CA 950355543

    Phone: (408) 263-2040

    Fax: (408) 946-2020

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $405.

Total Amount is formed as General ($405) + Research ($0) + Ownership ($0) = $405.

Last reported payment date: 2024-07-17 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($343).

Total Amount

$405

General + Research + Ownership

Payments

5

Total payment records

General Amount

$405

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2012-06-18

PECOS data refreshed: 2026-06-15

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
I20120618000034IOptometryCATBD

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 95138)

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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: 6406013143View full group profile
NameSpecialtyState
O P T O M E T R YCA
O P T O M E T R YCA
O P T O M E T R YCA
-CA
O P T O M E T R YCA
O P T O M E T R YCA

Reviews

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Frequently asked questions

What NPI should I save for DR. NICOLE ANH PHAM (O. D.)?
Save NPI 1235119108 if you need a stable reference for DR. NICOLE ANH PHAM (O. D.).
Is DR. NICOLE ANH PHAM (O. D.) active in the national directory?
DR. NICOLE ANH PHAM (O. D.)'s public NPI profile is in an active state.
What kind of provider is DR. NICOLE ANH PHAM (O. D.)?
The page reflects Optometrist for DR. NICOLE ANH PHAM (O. D.). Clinical services aligned with this taxonomy classification.
Where is DR. NICOLE ANH PHAM (O. D.)'s primary listing?
We display San Jose, California because that is what the record indicates for DR. NICOLE ANH PHAM (O. D.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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