PAULINE QUYNH PHAN – Specialist, NPI 1417419680
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
251 PSYCHIATRY in NV
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Provider Addresses for PAULINE QUYNH PHAN
130, West Charleston Boulevard, 18b Arts District, Las Vegas, Clark County, Nevada, 89102, United States
LAS VEGAS, NV 891020083
Phone: (702) 671-5127
Type: Location
902 S MYRTLE AVE
MONROVIA, CA 910163427
Phone: (626) 357-3258
Type: Mailing
1000 W CARSON ST # 498
TORRANCE, CA 905022004
Phone: (424) 306-5700
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $133.
Total Amount is formed as General ($133) + Research ($0) + Ownership ($0) = $133.
Last reported payment date: 2023-12-06 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($133).
Total Amount
$133
General + Research + Ownership
Payments
2
Total payment records
General Amount
$133
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $133 |
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: 2024-10-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241009004267 | I | Psychiatry | CA | TBD |
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.
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 89102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | CA | |
| Clinical Psychologist | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | IL | |
| - | CA |
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