DR. MAI TRUC PHAN (MD) – Family Medicine Physician, NPI 1255321998

DR. MAI TRUC PHAN (MD) is a healthcare provider. based in Charlestown, Massachusetts. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 153182 (MA). The NPI Number for DR. MAI TRUC PHAN (MD) is 1255321998

Main info

Female
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. MAI TRUC PHAN (MD)
NPI
1255321998
Phone
(617) 267-7171
Address
PO BOX 9142
Enumeration Date
25 October 2005
Last Update Date
26 November 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6172677171
Graduation Year
1984 (42 years ago)
PAC ID
3971591553
Group Practice PAC ID
6507803806
Professional Enrollment ID
I20040503001345
Address ID
MA022152800BO388XXAVEX300
Telehealth
Yes
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

1,899 FAMILY PRACTICE in MA

Provider Addresses for DR. MAI TRUC PHAN (MD)

  • Charlestown Post Office (mobile), Pattern Close, St Austell Bay, Charlestown, Cornwall, England, PL25 3FQ, United Kingdom

    MASS GENERAL PHYSICIAN ORGANIZATION

    CHARLESTOWN, MA 021299142

    Phone: (617) 267-7171

    Fax: (617) 262-2608

    Type: Mailing

  • 388 COMMONWELATH AVE MBB

    MGH BACK BAY

    BOSTON, MA 022152800

    Phone: (617) 267-7171

    Fax: (617) 262-2608

    Type: Location

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: 2004-05-03

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
I20040503001345IFamily PracticeMATBD

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
99214Established patient office or other outpatient visit, 30-39 minutes146106$0
99213Established patient office or other outpatient visit, 20-29 minutes3227$0
99443Telephone medical discussion with physician, 21-30 minutes3122$0
View full utilization report →

Insurance plans in this area (ZIP 02129)

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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: 6507803806View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMA
Internal MedicineMA
-MA
-MA
Anesthesiology, Pain ManagementMA
-MA
Clinical PsychologistMA
Internal MedicineMA
Internal MedicineMA
-MA

Reviews

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Frequently asked questions

Can I cross-check DR. MAI TRUC PHAN (MD) using NPI 1255321998?
NPI 1255321998 belongs to DR. MAI TRUC PHAN (MD); compare other details if you need extra assurance.
Is there an active status for DR. MAI TRUC PHAN (MD)?
For scheduling context, DR. MAI TRUC PHAN (MD) is shown as active in the registry.
What kind of doctor is DR. MAI TRUC PHAN (MD)?
DR. MAI TRUC PHAN (MD) is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Massachusetts is DR. MAI TRUC PHAN (MD) registered?
Use Charlestown, Massachusetts as the headline location for DR. MAI TRUC PHAN (MD) here.
When was this NPI issued?
Enumeration for DR. MAI TRUC PHAN (MD) is noted as October 25, 2005 where the registry provides it.

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