Individual provider Active NPI

Duong Tran, N.P.

  • Gerontology Nurse Practitioner
  • Templeton, CA
National Provider Identifier
1164878773
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95004335 Issued in CA
Practice address
325 Posada LN
A
Templeton, CA 93465-4003
Phone
(805) 542-6700
Fax
(805) 542-6791
NPI assigned
May 12, 2016
Reactivated
Sep 21, 2023
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95004335 CA Primary

Addresses

Primary practice location

325 Posada LN
A
Templeton, CA 93465-4003

Mailing address

10333 El Camino Real
Atascadero, CA 93422-5808
Phone (805) 468-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018003036 CA Practitioner - Nurse Practitioner 6800184201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

10333 El Camino Real
Atascadero State Hospital
Atascadero, CA 93423-7001
Phone (916) 651-8811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Sep 5, 2023 Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: duong.tran.1@9312.direct.athenahealth.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 3

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1164878773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 POSADA LN",
            "address_2": "A",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654003",
            "telephone_number": "805-542-6700",
            "fax_number": "805-542-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DUONG",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "deactivation_date": "2023-09-15",
        "reactivation_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95004335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

Verify at the official NPI Registry.