Individual provider Active NPI

Tony Tran, OD

  • Optometrist
  • Waterbury, CT
National Provider Identifier
1487212346
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3134 Issued in CT
Practice address
87 Grandview Ave
Waterbury, CT 06708-2514
Phone
(203) 805-7022
Fax
(203) 596-2230
NPI assigned
Jun 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5348 MA
Optometrist 152W00000X 3134 CT Primary

Addresses

Primary practice location

87 Grandview Ave
Waterbury, CT 06708-2514

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other practice location 1

22 University Dr
Amherst, MA 01002-2243
Phone (413) 549-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190806000693 MA Practitioner - Optometry 5597092130 Reassigns benefits to 1 organization
I20191111001650 CT Practitioner - Optometry 5597092130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Massachusetts P CGroup PAC ID 1951661297, 57 clinicians
Myeyedr Optometry of Connecticut LLCGroup PAC ID 1557666237, 70 clinicians

Practice addresses (Care Compare)

12 Hamburg St
Springfield, MA 01107-1327
Phone (413) 733-0867

1457 Whalley Ave
New Haven, CT 06515-1153
Phone (203) 387-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5348MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Jun 23, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Jun 23, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Oct 25, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Oct 25, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Past Accepting new patients

Locations

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

1457 Whalley Ave
New Haven, CT 06515
Phone (203) 387-3937

93 Evergreen Way
Unit C
South Windsor, CT 06074
Phone (860) 633-4362

1249 W Main St
Ste 1
Waterbury, CT 06708
Phone (203) 805-7022

87 Grandview Ave
Waterbury, CT 06708
Phone (203) 465-1353

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

27 Memorial Pkwy
Randolph, MA 02368
Phone (617) 986-7400

12 Hamburg St
Springfield, MA 01107
Phone (413) 733-0867

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1487212346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-805-7022",
            "fax_number": "203-596-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 University Dr",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010022243",
            "country_code": "US",
            "telephone_number": "413-549-9400",
            "fax_number": "413-549-0222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TONY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5348",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.