Individual provider Active NPI

Van Tran, NP

  • Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1043867062
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95012043 Issued in CA
Practice address
801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433
Phone
(818) 265-2264
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95012043 CA Primary

Addresses

Primary practice location

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433

Mailing address

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226001969 CA Practitioner - Nurse Practitioner 9032543178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Community Health Centers IncGroup PAC ID 9638082456, 47 clinicians

Practice addresses (Care Compare)

801 S Chevy Chase Dr
Suite 250
Glendale, CA 91205-4433
Phone (818) 265-2264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers Inc CurrentSince Oct 6, 2019 Accepting new patients
Comprehensive Community Health Centers, Inc CurrentSince Oct 6, 2019 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1043867062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433",
            "telephone_number": "818-265-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "VAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.