Individual provider Active NPI

Phung Tran, DO

  • Family Medicine Physician
  • Vestal, NY
National Provider Identifier
1104313774
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
308131 Issued in NY
Practice address
3101 Shippers Rd Ste 203
Vestal, NY 13850-2082
Phone
(607) 786-4822
Fax
(607) 251-2010
NPI assigned
Apr 18, 2018
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 308131 NY Primary

Addresses

Primary practice location

3101 Shippers Rd Ste 203
Vestal, NY 13850-2082

Mailing address

247 Riverside Dr
Binghamton, NY 13905-4058
Phone (607) 972-9916

Other practice location 1

169 Riverside Dr
Binghamton, NY 13905-4198
Phone (607) 798-5111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TranPhungKim@direct.lourdes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210830001868 NY Practitioner - Family Practice 7214332295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3101 Shippers Rd
Suite 203
Vestal, NY 13850-2082
Phone (607) 786-4822

732 Vestal Pkwy E
Suite 6a
Vestal, NY 13850-1687
Phone (607) 323-1339

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Family Medicine Current Accepting new patients
Dr. P. Tran's Osteopathic Touch PLLC Family Medicine CurrentSince Jan 20, 2026 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Oct 15, 2021 Accepting new patients
Cardiometabolic Medicine PC CurrentSince Jan 20, 2026 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

303 Main St
Binghamton, NY 13905
Phone (607) 729-8687

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

3101 Shippers Rd
Ste 203
Vestal, NY 13850
Phone (607) 786-4822

732 Vestal Pkwy E
Ste 6A
Vestal, NY 13850
Phone (607) 323-1339

Interoperability endpoints

  • Direct secure messaging: tphung187987@direct-guthrie.org
  • Direct secure messaging: tranphungkim@direct.lourdes.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1104313774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054058",
            "telephone_number": "607-972-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SHIPPERS RD STE 203",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502082",
            "telephone_number": "607-786-4822",
            "fax_number": "607-251-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139054198",
            "country_code": "US",
            "telephone_number": "607-798-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHUNG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "308131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TranPhungKim@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "169 Riverside Dr",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139054246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.