NPIMap

Individual provider Active NPI

Lily N Tran, DO

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1265489330
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L7584 Issued in TX
Practice address
2550 River Park PLZ
Suite 110
Fort Worth, TX 76116-0920
Phone
(817) 731-1289
Fax
(817) 731-1291
NPI assigned
May 27, 2006
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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 L7584 TX Primary

Addresses

Primary practice location

2550 River Park PLZ
Suite 110
Fort Worth, TX 76116-0920

Mailing address

2550 River Park PLZ
Suite 110
Fort Worth, TX 76116-0920
Phone (817) 731-1289

Other identifiers 3

IdentifierTypeStateIssuer
185208903MedicaidTX
185208902MedicaidTX
185208905MedicaidTX

Other names 1

  • Lily Nguyen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070627000351 TX Practitioner - Family Practice 8123127487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quang Trong Le DO PAGroup PAC ID 6800850470, 12 clinicians

Practice addresses (Care Compare)

2550 River Park PLZ
Suite 110
Fort Worth, TX 76116-0921
Phone (817) 731-1289

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quang Trong Le DO PA Family Medicine CurrentSince Apr 5, 2015 Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients
United Investors LP Past Accepting new patients
Ignite Medical Resort Fort Worth, LLC Past Accepting new patients

Locations

2550 River Park Plz
Ste 110
Ft Worth, TX 76116
Phone (817) 731-1289

Organizations & group practices 4

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 6

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1265489330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 RIVER PARK PLZ",
            "address_2": "SUITE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761160920",
            "telephone_number": "817-731-1289",
            "fax_number": "817-731-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 RIVER PARK PLZ",
            "address_2": "SUITE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761160920",
            "telephone_number": "817-731-1289",
            "fax_number": "817-731-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "LILY",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L7584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185208903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185208902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185208905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILY",
            "last_name": "NGUYEN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.