Individual provider Active NPI

Wendy Tran, MD

  • Family Medicine Physician
  • College Station, TX
National Provider Identifier
1114424975
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T3402 Issued in TX
Practice address
1602 Rock Prairie Rd Ste 2400
College Station, TX 77845-0001
Phone
(979) 693-2586
Fax
(979) 693-7327
NPI assigned
Apr 9, 2018
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X T3402 TX Primary

Addresses

Primary practice location

1602 Rock Prairie Rd Ste 2400
College Station, TX 77845-0001

Mailing address

1602 Rock Prairie Rd Ste 2400
College Station, TX 77845-0001
Phone (979) 693-2586

Other identifiers 1

IdentifierTypeStateIssuer
430258001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210913001696 TX Practitioner - Family Practice 0840541736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

1602 Rock Prairie Rd
Suite 2400
College Station, TX 77845-0001
Phone (979) 693-2586

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3402TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
St Joseph Regional Health Center CurrentSince Nov 1, 2021 Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Interoperability endpoints

  • Direct secure messaging: wendy.tran@sjrhc.eclinicaldirectplus.com

Organizations & group practices 3

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 2

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1114424975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 2400",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778450001",
            "telephone_number": "979-693-2586",
            "fax_number": "979-693-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 2400",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778450001",
            "telephone_number": "979-693-2586",
            "fax_number": "979-693-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "WENDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430258001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.