MIADETTE PHENG-PHAL (NP-C) – Primary Care Nurse Practitioner, NPI 1073044616

MIADETTE PHENG-PHAL (NP-C) is a healthcare provider. based in Lynn, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN2270203 (MA). The NPI Number for MIADETTE PHENG-PHAL (NP-C) is 1073044616

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MIADETTE PHENG-PHAL (NP-C)
NPI
1073044616
Phone
Not provided
Address
269 UNION ST
Enumeration Date
24 March 2017
Last Update Date
24 March 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7817807755
Graduation Year
2016 (10 years ago)
PAC ID
2163793944
Group Practice PAC ID
3779846241
Professional Enrollment ID
I20170814001007
Address ID
MA019011353LY280XXSTXX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

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Provider Addresses for MIADETTE PHENG-PHAL (NP-C)

  • 269, Union Street, Lynn, Essex County, Massachusetts, 01901, United States

    LYNN, MA 019011314

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $556.

Total Amount is formed as General ($556) + Research ($0) + Ownership ($0) = $556.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($233).

Total Amount

$556

General + Research + Ownership

Payments

27

Total payment records

General Amount

$556

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

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: 2017-08-14

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
I20170814001007INurse PractitionerMATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes37555$0
99442Telephone medical discussion with physician, 11-20 minutes16083$0
99213Established patient office or other outpatient visit, 20-29 minutes11265$0
99443Telephone medical discussion with physician, 21-30 minutes7441$0
99214Established patient office or other outpatient visit, 30-39 minutes6339$0
View full utilization report →

Insurance plans in this area (ZIP 01901)

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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: 3779846241View full group profile
NameSpecialtyState
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Internal MedicineMA
-MA
Nurse PractitionerMA

Reviews

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Frequently asked questions

How do payers reference MIADETTE PHENG-PHAL (NP-C)?
For MIADETTE PHENG-PHAL (NP-C), use NPI 1073044616 as the unique 10-digit identifier.
Would MIADETTE PHENG-PHAL (NP-C) appear as active to a payer?
You can treat MIADETTE PHENG-PHAL (NP-C) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to MIADETTE PHENG-PHAL (NP-C)?
MIADETTE PHENG-PHAL (NP-C)'s specialty line reads Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MIADETTE PHENG-PHAL (NP-C) associated with Lynn?
Public fields place MIADETTE PHENG-PHAL (NP-C) around Lynn, Massachusetts. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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