Individual provider Active NPI

Michael Long Tran, MD

  • Anesthesiology Physician
  • Santa Rosa, CA
National Provider Identifier
1013927110
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G085353 Issued in CA
Practice address
4704 Hoen Ave
Santa Rosa, CA 95405
Phone
(707) 546-7979
Fax
(707) 546-7667
NPI assigned
Aug 9, 2006
Last updated
Jul 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G085353 CA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X G085353 CA

Addresses

Primary practice location

4704 Hoen Ave
Santa Rosa, CA 95405

Mailing address

4704 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 546-7979

Other identifiers 2

IdentifierTypeStateIssuer
159045000OtherCAUS DEPT OF LABOR
P00124747OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616001537 CA Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Physical Medicine and Rehabilitation 6002890027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology, Physical Medicine and Rehabilitation
Education
Oregon Health Sciences University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2463 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone (707) 546-7979

4704 Hoen Ave
Santa Rosa, CA 95405-7824

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G085353CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Pain Management Group, Inc. Pain Medicine CurrentSince Jan 1, 2011 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Sutter Coast Hospital Past Accepting new patients
Riverside Medical Group PC Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
North Coast Medical Center Inc Anesthesiology PastSince Feb 7, 2008 Accepting new patients

Locations

2463 Summerfield Rd
Santa Rosa, CA 95405
Phone (707) 527-7535

4704 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 546-7979

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1013927110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-546-7979",
            "fax_number": "707-546-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-546-7979",
            "fax_number": "707-546-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MICHAEL",
        "middle_name": "LONG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G085353",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G085353",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "159045000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00124747",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.