Individual provider Active NPI

Minh Q Tran, M.D.

  • Pediatric Critical Care Medicine Physician
  • Shreveport, LA
National Provider Identifier
1194059386
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
301810 Issued in LA
Practice address
2510 Bert Koun Loop
Room 4003
Shreveport, LA 71118-3119
Phone
(318) 212-5665
Fax
(318) 212-5698
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 301810 LA Primary

Addresses

Primary practice location

2510 Bert Koun Loop
Room 4003
Shreveport, LA 71118-3119

Mailing address

2510 Bert Koun Loop
Room 4003
Shreveport, LA 71118-3119
Phone (318) 212-5665

Other identifiers 1

IdentifierTypeStateIssuer
2422481MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200915001241 LA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 0446409841 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WK Pediatric Intensivist Pediatric Critical Care Medicine CurrentSince Jun 1, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 27, 2020 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 27, 2020 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients

Locations

1203 S Tyler St
Covington, LA 70433
Phone (985) 875-2234

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

2508 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5880

2510 Bert Kouns Industrial Loop
Rm 4003
Shreveport, LA 71118
Phone (318) 212-5665

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

Interoperability endpoints

  • Direct secure messaging: mtran@direct.wkhs.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1194059386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUN LOOP",
            "address_2": "ROOM 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUN LOOP",
            "address_2": "ROOM 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MINH",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "301810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2422481",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.