Individual provider Active NPI

Justin Tran, OD

  • Optometrist
  • Orlando, FL
National Provider Identifier
1508602319
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6546 Issued in FL
Practice address
425 S Avalon Park Blvd Ste 300
Orlando, FL 32828-6701
Phone
(407) 658-6580
NPI assigned
Jul 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPC6546 FL Primary

Addresses

Primary practice location

425 S Avalon Park Blvd Ste 300
Orlando, FL 32828-6701

Mailing address

1100 Lake Shadow Cir Apt 2202
Maitland, FL 32751-7548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240730004140 FL Practitioner - Optometry 5991242695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
You and Eyes, Inc.Group PAC ID 8426234287, 2 clinicians

Practice addresses (Care Compare)

425 S Avalon Park Blvd
Suite 300
Orlando, FL 32828-6701
Phone (407) 658-6580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
You & Eyes, Inc. Optometrist CurrentSince Jul 19, 2024 Accepting new patients

Locations

425 S Avalon Park Blvd
Ste 300
Orlando, FL 32828
Phone (407) 658-6580

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1508602319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE SHADOW CIR APT 2202",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S AVALON PARK BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286701",
            "telephone_number": "407-658-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JUSTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.