Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tin Viet Phan

Individual provider Physician Assistant · NPI 1134803059

Tin Viet Phan is a Physician Assistant in Longmeadow, Massachusetts. Qualified in 2025, 1 year ago. Practices with Le and Chang Family Urgent Care PC, a 3-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
1
Licensed in
MA
In the registry since
2023
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Practice location Address checks out

588 Longmeadow St
Longmeadow, MA 01106-2212
Phone: (413) 565-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 780 Albany St, Boston, MA 02118-2755 — (857) 654-1000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA101877 (MA)

Record details

NPI number1134803059
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 12, 2023
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026
Mailing address588 Longmeadow St, Longmeadow, MA 01106-2212

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Le And Chang Family Urgent Care Pc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Longmeadow