Individual provider Active NPI

Jade Connie Tran, M.D.,M.P.H.

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1609195981
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A112503 Issued in CA
Practice address
11234 Anderson St Ste 1617
Johns Hopkins Hospital - Taussig Heart Center
Loma Linda, CA 92354-2804
Phone
(909) 558-4207
Fax
(410) 955-0897
NPI assigned
May 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A112503 CA Primary
Children's Hospital 282NC2000X T8182 MD
Cardiovascular Disease Physician 207RC0000X A112503 CA
Pediatric Cardiology Physician 2080P0202X A112503 CA
Hypertension Specialist Physician 207RH0005X A112503 CA

Addresses

Primary practice location

11234 Anderson St Ste 1617
Johns Hopkins Hospital - Taussig Heart Center
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St Ste 1617
Loma Linda University Health - International Heart Inst
Loma Linda, CA 92354-2804
Phone (909) 558-4207

Other identifiers 1

IdentifierTypeStateIssuer
A112503OtherCACALIFORNIA STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000522 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 2668630054 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T8182MDMDChildren's Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2015 Accepting new patients
Faculty Physicians and Surgeons of Llusm Cardiovascular Disease Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients

Locations

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11234 Anderson St
Ste 1617
Loma Linda, CA 92350
Phone (909) 558-2848

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jtran82901@direct.llu.edu
  • Direct secure messaging: jtran850163@direct.memorialcare.org

Organizations & group practices 4

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1609195981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST STE 1617",
            "address_2": "LOMA LINDA UNIVERSITY HEALTH - INTERNATIONAL HEART INST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4207",
            "fax_number": "410-955-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST STE 1617",
            "address_2": "JOHNS HOPKINS HOSPITAL - TAUSSIG HEART CENTER",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4207",
            "fax_number": "410-955-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JADE",
        "middle_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "M.D.,M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A112503",
            "primary": true
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "MD",
            "license": "T8182",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A112503",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A112503",
            "primary": false
        },
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "CA",
            "license": "A112503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "A112503",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.