Individual provider Active NPI

Stephanie Tran DO, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1649533555
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A121644 Issued in CA
Practice address
1200 N State St
Room Cta7D
Los Angeles, CA 90033-1029
Phone
(323) 226-5700
NPI assigned
Jun 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A121644 CA Primary

Addresses

Primary practice location

1200 N State St
Room Cta7D
Los Angeles, CA 90033-1029

Mailing address

1200 N State St
Room Cta7D
Los Angeles, CA 90033-1029

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.do.p1@direct.eisnerhealth.nextgenshare.com Health Information Exchange (HIE)
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20150401000300 CA Practitioner - Pediatric Medicine 3678890647 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121644CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic CurrentSince Dec 19, 2023 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 10, 2015 Accepting new patients
Venice Family Clinic Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 10, 2015 Accepting new patients
Venice Family Clinic CurrentSince Dec 19, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • Direct secure messaging: sdo753336@direct.ochin.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1649533555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "ROOM CTA7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "ROOM CTA7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "STEPHANIE",
        "middle_name": "TRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A121644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.do.p1@direct.eisnerhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGenShare, Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1530 S Olive St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900153023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.