Individual provider Active NPI

Benjamin Alfred Tran, MD

  • Dermatology Physician
  • Pasadena, CA
National Provider Identifier
1386263317
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A195888 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 200
Pasadena, CA 91105-2651
Phone
(626) 793-7790
Fax
(626) 793-9018
NPI assigned
Apr 9, 2020
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A195888 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 200
Pasadena, CA 91105-2651

Mailing address

625 S Fair Oaks Ave Ste 200
Pasadena, CA 91105-2651
Phone (626) 793-7790

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016003447 CA Practitioner - Dermatology 1355873233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Virginia School of Medicine, 2020
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

625 S Fair Oaks Ave
Suite 200
Pasadena, CA 91105-2651

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions885
Removal or shaving of skin growth1-10
Skin biopsy247

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195888CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Dermatology Center of Pasadena, a Medical Group CurrentSince Sep 16, 2024 Accepting new patients

Locations

625 S Fair Oaks Ave
Ste 200
Pasadena, CA 91105
Phone (626) 793-7065

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1386263317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052651",
            "telephone_number": "626-793-7790",
            "fax_number": "626-793-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052651",
            "telephone_number": "626-793-7790",
            "fax_number": "626-793-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "BENJAMIN",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A195888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.