Amy Pham, RDN is a medicare enrolled "Dietitian, Registered" provider in West Valley City, Utah. Her current practice location is
3535 S Market St Ste 900, West Valley City, Utah. You can reach out to her office (for appointments etc.) via phone at
(385) 430-1430.
Amy Pham is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164130258.
Healthcare Provider's Profile
| Full Name | Amy Pham |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 3535 S Market St Ste 900, West Valley City, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164130258
- Provider Enumeration Date: 11/08/2022
- Last Update Date: 04/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 1658728985
- Enrollment ID: I20231108002422
Medical Identifiers
Medical identifiers for Amy Pham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1164130258 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy Pham allows following entities to bill medicare on her behalf.
| Provider Name | Metrodora Clinic, Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1124762281
PECOS PAC ID: 8628430766
Enrollment ID: O20230822000226 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Pham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amy Pham, RDN
640 E Wilmington Ave Unit A202,
Salt Lake City, UT 84106-1001
Ph: () - | Amy Pham, RDN
3535 S Market St Ste 900,
West Valley City, UT 84119-3651
Ph: (385) 430-1430 |
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