Individual provider Active NPI

Christina Ruby Tran, OD

  • Optometrist
  • Aurora, CO
National Provider Identifier
1083222459
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0003584 Issued in CO
Practice address
15121 E Mississippi Ave
Aurora, CO 80012-3746
Phone
(303) 802-1022
NPI assigned
Jul 21, 2020
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0003584 CO Primary

Addresses

Primary practice location

15121 E Mississippi Ave
Aurora, CO 80012-3746

Mailing address

11084 Branching Horn
Eden Prairie, MN 55347-4923
Phone (612) 877-0355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260610004358 MN Practitioner - Optometry 1951873900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11084 Branching Horn
Eden Prairie, MN 55347-4923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003584COMDOptometrist

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, 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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1083222459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11084 BRANCHING HORN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474923",
            "telephone_number": "612-877-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15121 E MISSISSIPPI AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123746",
            "telephone_number": "303-802-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CHRISTINA",
        "middle_name": "RUBY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.