Individual provider Active NPI

Trang Uyen DO, M.D.

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1063442663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76681 Issued in CA
Practice address
2114 Senter Rd
Suite 15
San Jose, CA 95112-2608
Phone
(408) 975-9800
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A76681 CA Primary

Addresses

Primary practice location

2114 Senter Rd
Suite 15
San Jose, CA 95112-2608

Mailing address

2114 Senter Rd
Suite 15
San Jose, CA 95112-2608
Phone (408) 975-9800

Other identifiers 1

IdentifierTypeStateIssuer
00A766810MedicaidCA

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
I20041004000801 CA Practitioner - Internal Medicine 5890754154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2114 Senter Rd
Suite 15
San Jose, CA 95112-2608
Phone (408) 794-8797

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76681CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Trang Uyen DO, M.D., Inc Internal Medicine CurrentSince Oct 17, 2005 Accepting new patients
Permanente Medical Group, Inc Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

2114 Senter Rd
Ste 15
San Jose, CA 95112
Phone (408) 794-8797

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063442663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 SENTER RD",
            "address_2": "SUITE 15",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951122608",
            "telephone_number": "408-975-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 SENTER RD",
            "address_2": "SUITE 15",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951122608",
            "telephone_number": "408-975-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "TRANG",
        "middle_name": "UYEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A766810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.