Individual provider Active NPI

Kevin Tran, PT, DPT

  • Physical Therapist
  • Costa Mesa, CA
National Provider Identifier
1568175461
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303475 Issued in CA
Practice address
2777 Bristol St Ste B
Costa Mesa, CA 92626-5997
Phone
(949) 250-1112
NPI assigned
Jan 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 303475 CA Primary

Addresses

Primary practice location

2777 Bristol St Ste B
Costa Mesa, CA 92626-5997

Mailing address

16315 Mount Islip Cir
Fountain Valley, CA 92708-2134
Phone (714) 860-0303

Other names 1

  • Dr. Pham Tran Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119002391 CA Practitioner - Physical Therapist in Private Practice 6406227982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26672 Portola Pkwy
Suite 116
Foothill Ranch, CA 92610-1773
Phone (714) 450-4999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303475CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist Current Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Jan 3, 2023 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Jan 3, 2023 Accepting new patients

Locations

559 E Carson St
Ste B
Carson, CA 90745
Phone (424) 201-5242

2777 Bristol St
Ste B
Costa Mesa, CA 92626
Phone (949) 250-1112

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

Organizations & group practices 3

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1568175461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16315 MOUNT ISLIP CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082134",
            "telephone_number": "714-860-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 BRISTOL ST STE B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265997",
            "telephone_number": "949-250-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHAM",
            "last_name": "TRAN",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.