Individual provider Active NPI

Theresa Thanh Thuy Tran

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1053919142
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Park PLZ Ste 600
Irvine, CA 92614-5987
Phone
(949) 515-7300
NPI assigned
Oct 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1 Park PLZ Ste 600
Irvine, CA 92614-5987

Mailing address

1 Park PLZ Ste 600
Irvine, CA 92614-5987
Phone (949) 515-7300

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
I20260611004646 CA Practitioner - Physician Assistant 2163994930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15221 Purdy St
Westminster, CA 92683-6313

330 Avenida Santa Margarita
San Clemente, CA 92672-3455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1053919142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK PLZ STE 600",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145987",
            "telephone_number": "949-515-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK PLZ STE 600",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145987",
            "telephone_number": "949-515-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THERESA",
        "middle_name": "THANH THUY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.