Fawn Tran, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD22331 Issued in OR

Practice address

10200 SW Eastridge St
Suite 205
Portland, OR 97225-5064

Phone

(503) 280-4555

Fax

(503) 280-4559

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 24, 2018 through Jun 24, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cedar Creek Internal Medicine,PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1265517437
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1346353646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 SW EASTRIDGE ST",
            "address_2": "SUITE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255064",
            "telephone_number": "503-280-4555",
            "fax_number": "503-280-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 SW EASTRIDGE ST",
            "address_2": "SUITE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255064",
            "telephone_number": "503-280-4555",
            "fax_number": "503-280-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "FAWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD22331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500614183",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE- PROVIDENCE",
            "identifier": "P01165691",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Khai Tran, D.C.
• Diane Tran, DC
• Duy Quang Tran, M.D.
• Elaine Tran
• Emma Lan Thanh Tran, RPH
• Faye H Tran, DA
• Forest Thao Tran
• Hannah Laury Tran
• Hieu CHI Tran, RPH
• Hung Viet Tran, PHARMACIST

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.