Individual provider Active NPI

Michael Quan Anh Tran, OD

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1417635517
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2929 Issued in MD
Practice address
10 N Greene St
Baltimore, MD 21201-1524
Phone
(410) 605-7230
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2929 MD Primary

Addresses

Primary practice location

10 N Greene St
Baltimore, MD 21201-1524

Mailing address

4112 North Keystone Avenue Apt. #1E
Chicago, IL 60641
Phone (868) 254-3041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241008001488 IL Practitioner - Optometry 1658802186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

8035 Lincoln Ave
Skokie, IL 60077-3612
Phone (847) 679-1775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2929MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Optical Co., Inc. Optometrist CurrentSince Aug 19, 2024 Accepting new patients
Rosin Optical Co. Inc. Optometrist CurrentSince Aug 19, 2024 Accepting new patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients
Rosin Optical Co., Inc. Optometrist Past Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

8035 Lincoln Ave
Skokie, IL 60077
Phone (847) 679-1775

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1417635517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 NORTH KEYSTONE AVENUE APT. #1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60641",
            "telephone_number": "868-254-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MICHAEL",
        "middle_name": "QUAN ANH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.