Brian Phan Tran, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

277792-1 Issued in NY

Practice address

2651 Clearview Dr
Endicott, NY 13760-7015

Phone

(607) 727-5683

NPI assigned

May 9, 2011

Last updated

Dec 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: btran@pedassocwtn.medentdirect.com
• Direct secure messaging: tranb2@hiemail.healtheconnections.org

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.

• Pediatric Associates of Watertown P.C.

  • Pediatrics Physician
  • Watertown, NY
  • NPI 1497855670
  NPD (past)
• River View Pediatrics, PC

  • Pediatric Adolescent Medicine Physician
  • Fulton, NY
  • NPI 1831401850
  NPD (past)

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1093007098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 CLEARVIEW DR",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137607015",
            "telephone_number": "607-727-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 CLEARVIEW DR",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137607015",
            "telephone_number": "607-727-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "BRIAN",
        "middle_name": "PHAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "277792-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Smile Designers
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• Pediatrics Physician in Endicott, NY
• Providers in Endicott, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.