Individual provider Active NPI

Khoa D Tran, MD

  • Psychiatry Physician
  • Erie, PA
National Provider Identifier
1427013986
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD422041 Issued in PA
Practice address
232 W 25TH St # 3R
Erie, PA 16544-6929
Phone
(814) 452-5530
Fax
(814) 452-5419
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-079729 OH
Psychiatry Physician 2084P0800X MD422041 PA Primary

Addresses

Primary practice location

232 W 25TH St # 3R
Erie, PA 16544-6929

Mailing address

153 E 13TH St Ste 1300
Erie, PA 16503-1035
Phone (814) 452-5530

Other identifiers 1

IdentifierTypeStateIssuer
2317139MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktran149320@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040712000359 OH Practitioner - PsychiatryPractitioner - Family Practice 5799763207 Reassigns benefits to 2 organizations
I20071120000456 PA Practitioner - Psychiatry 5799763207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

232 W 25TH St
SV Pediatric Hospitalist Group
Erie, PA 16544-0002
Phone (814) 452-5216

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-6969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-079729OHMDPsychiatry Physician
MD422041PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Medical Center CurrentSince Jun 1, 2004 Accepting new patients
St Vincent Medical Education and Research Institute Inc Psychiatry CurrentSince Jan 1, 2008 Accepting new patients
Northwest Beacon Group LLC Past Accepting new patients
Ashtabula County Medical Center Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

2422 Lake Ave
Ashtabula, OH 44004
Phone (440) 992-4422

2863 State Route 45 N
Rock Creek, OH 44084
Phone (440) 563-3400

155 E State St
Albion, PA 16401
Phone (814) 756-4917

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

232 W 25th St
#3R
Erie, PA 16544
Phone (814) 452-5530

8300 Ridge Rd
Girard, PA 16417
Phone (814) 474-5521

Interoperability endpoints

  • Direct secure messaging: ktran149320@direct.ahn.org
  • Direct secure messaging: ktran327815@direct.ochin.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1427013986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 E 13TH ST STE 1300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031035",
            "telephone_number": "814-452-5530",
            "fax_number": "814-452-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 W 25TH ST # 3R",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165446929",
            "telephone_number": "814-452-5530",
            "fax_number": "814-452-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KHOA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-079729",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD422041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2317139",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktran149320@direct.ahn.org",
            "affiliation": "N",
            "address_1": "232 W 25th St # 3R",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165446929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.