Individual provider Active NPI

My Tho Karin Tran, OD, MS

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1497157192
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
670 Issued in NM
Practice address
1600 University Blvd NE
Albuquerque, NM 87102-1724
Phone
(505) 272-2553
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 670 NM Primary

Addresses

Primary practice location

1600 University Blvd NE
Albuquerque, NM 87102-1724

Mailing address

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106-4374
Phone (505) 272-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20160106001243 NM Practitioner - Optometry 8022310192 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
670NMMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Albuquerque Vision Clinic LLC Optometrist CurrentSince Oct 18, 2021 Accepting new patients

Locations

5343 Wyoming Blvd NE
Ste 2
Albuquerque, NM 87109
Phone (505) 332-2020

Organizations & group practices 2

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1497157192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-1320",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021724",
            "telephone_number": "505-272-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MY THO",
        "middle_name": "KARIN",
        "name_prefix": "Dr.",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.