Individual provider Active NPI

Anh Thu Thi Tran, DO

  • General Practice Physician
  • San Jose, CA
National Provider Identifier
1609366459
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A19010 Issued in CA
Practice address
227 N Jackson Ave # 205
San Jose, CA 95116-1603
Phone
(408) 279-2377
Fax
(408) 279-2395
NPI assigned
May 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 20A19010 CA Primary

Addresses

Primary practice location

227 N Jackson Ave # 205
San Jose, CA 95116-1603

Mailing address

227 N Jackson Ave Ste 205
San Jose, CA 95116-1603
Phone (408) 279-2377

Other practice location 1

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-4417 ext. 42300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19010CAMDGeneral Practice Physician
19010CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Health Medical Foundation Multi-Specialty CurrentSince Sep 1, 2021 Accepting new patients
Richard J Trevino MD a Professional Corporation Multi-Specialty PastSince Sep 28, 2021 Accepting new patients

Locations

227 N Jackson Ave
#205
San Jose, CA 95116
Phone (408) 279-2377

227 N Jackson Ave
Ste 235
San Jose, CA 95116
Phone (408) 254-9192

227 N Jackson Ave
Ste I205
San Jose, CA 95116
Phone (408) 254-9192

227 N Jackson Ave
Ste 205
San Jose, CA 95116

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": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1609366459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE STE 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-279-2377",
            "fax_number": "408-279-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE # 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-279-2377",
            "fax_number": "408-279-2395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Childrens Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731044637",
            "country_code": "US",
            "telephone_number": "405-271-4417 x42300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "ANH THU",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A19010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.