Individual provider Active NPI

Caroline H Tran

  • Medical Physician Assistant
  • Indio, CA
National Provider Identifier
1417627159
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA62489 Issued in CA
Practice address
82151 Avenue 42 Ste 100
Indio, CA 92203-9313
Phone
(442) 224-6968
NPI assigned
Sep 15, 2021
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA62489 CA Primary

Addresses

Primary practice location

82151 Avenue 42 Ste 100
Indio, CA 92203-9313

Mailing address

82151 Avenue 42 Ste 100
Indio, CA 92203-9313
Phone (442) 224-6968

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523001911 CA Practitioner - Physician Assistant 5890151500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1850 Spring Ridge Dr
Susanville, CA 96130-6100
Phone 53025150001515

82151 Ave
42 Suite 100
Indio, CA 92203-9313
Phone (442) 215-1320

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA62489CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Rural Health Clinics CurrentSince May 1, 2023 Accepting new patients

Locations

1850 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 251-5000

1850 Spring Ridge Dr
Ste 1850
Susanville, CA 96130

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1417627159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 100",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "442-224-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 100",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "442-224-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CAROLINE",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.