Individual provider Active NPI

Baotram T. Tran, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1295920643
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4261 Issued in FL
Practice address
2201 E. Fowler Ave.
Ste. B
Tampa, FL 33612
Phone
(813) 972-1573
Fax
(813) 972-3081
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4261 FL Primary

Addresses

Primary practice location

2201 E. Fowler Ave.
Ste. B
Tampa, FL 33612

Mailing address

2201 E. Fowler Ave.
Ste. B
Tampa, FL 33612
Phone (813) 972-1573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080726000118 FL Practitioner - Optometry 0941373799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Eye Institute PA 31 clinicians

Practice addresses (Care Compare)

6585 126TH Ave
Unit D
Largo, FL 33773-1836
Phone (727) 541-4469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4261FLMDOptometrist

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Southeast Eye Institute, PA Optometrist CurrentSince Apr 1, 2021 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Nov 1, 2016 Accepting new patients

Locations

6585 126th Ave
Unit D
Largo, FL 33773
Phone (727) 541-4469

9375 66th St N
Pinellas Park, FL 33782
Phone (727) 541-4469

10755 Park Blvd
Seminole, FL 33772
Phone (727) 392-0907

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1295920643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 E. FOWLER AVE.",
            "address_2": "STE. B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-972-1573",
            "fax_number": "813-972-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 E. FOWLER AVE.",
            "address_2": "STE. B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-972-1573",
            "fax_number": "813-972-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "BAOTRAM",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.