Individual provider Active NPI

Kim Ngoc Tran, OD

  • Optometrist
  • Aurora, CO
National Provider Identifier
1033787064
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3715 Issued in CO
Practice address
6290 S Main St Ste 100
Aurora, CO 80016-5379
Phone
(303) 766-0545
Fax
(303) 766-0624
NPI assigned
Jun 16, 2021
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 3715 CO Primary

Addresses

Primary practice location

6290 S Main St Ste 100
Aurora, CO 80016-5379

Mailing address

5531 Atascocita Timbers N
Humble, TX 77346-2693
Phone (832) 794-5345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809003333 CO Practitioner - Optometry 0345644647 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southlands Vision AssociatesGroup PAC ID 6709880792, 5 clinicians
Altitude Eye Care at Castlerock PLLCGroup PAC ID 4688092711, 4 clinicians
5280 Vision Care, LLCGroup PAC ID 3173860244, 2 clinicians

Practice addresses (Care Compare)

6290 S Main St
Suite 100
Aurora, CO 80016-5379
Phone (303) 766-0545

6380 Promenade Pkwy
Suite a 100
Castle Rock, CO 80108-1909
Phone (720) 475-9991

7600 Park Meadows Dr
Suite 200
Lone Tree, CO 80124-2561
Phone (303) 754-0122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3715COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wagner Optometry PC Optometrist CurrentSince Jul 7, 2021 Accepting new patients
Southlands Vision Associates Optometrist CurrentSince Dec 1, 2023 Accepting new patients
Altitude Eye Care Optometrist CurrentSince Dec 1, 2023 Accepting new patients
Altitude Eye Care at Castlerock, PLLC Optometrist CurrentSince Dec 1, 2023 Accepting new patients
5280 Vision Care, LLC Optometrist CurrentSince Nov 5, 2023 Accepting new patients

Locations

6290 S Main St
Ste 100
Aurora, CO 80016
Phone (303) 766-0545

6380 Promenade Pkwy
Ste A100
Castle Rock, CO 80108
Phone (720) 475-9991

7600 Park Meadows Dr
Ste 200
Lone Tree, CO 80124
Phone (303) 754-0122

8405 Park Meadows Center Dr
Ste 1000
Lone Tree, CO 80124
Phone (303) 649-9500

10071 Wadsworth Pkwy
Ste 200
Westminster, CO 80021
Phone (303) 427-2020

Networks

  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • CO HMO C-SNP

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1033787064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5531 ATASCOCITA TIMBERS N",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462693",
            "telephone_number": "832-794-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 S MAIN ST STE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165379",
            "telephone_number": "303-766-0545",
            "fax_number": "303-766-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KIM",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "3715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.