Individual provider Active NPI

Tram Tran, P.T.

  • Physician Assistant
  • Plainview, NY
National Provider Identifier
1619170826
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011705 Issued in NY
Practice address
875 Old Country Rd
Ste 151
Plainview, NY 11803-4942
Phone
(516) 681-0202
NPI assigned
Jun 6, 2007
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011705 NY Primary
Physical Therapist 225100000X 011705 NY

Addresses

Primary practice location

875 Old Country Rd
Ste 151
Plainview, NY 11803-4942

Mailing address

875 Old Country Rd
Ste 151
Plainview, NY 11803-4942
Phone (516) 681-0202

Other identifiers 1

IdentifierTypeStateIssuer
011705OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000139 NY Practitioner - Physician Assistant 2163513375 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011705NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
G. F.G Medical, P.C PastSince Oct 1, 1997 Accepting new patients
Greater New York Physical Therapy and Chiropractic PLLC Physical Therapist PastSince Mar 1, 2012 Accepting new patients
North Coast Anesthesia LLC PastSince Mar 5, 2015 Accepting new patients
Long Island Anesthesiologists, PLLC Past Accepting new patients

Organizations & group practices 5

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1619170826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD",
            "address_2": "STE 151",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-681-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD",
            "address_2": "STE 151",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-681-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TRAM",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011705",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "011705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.