Active NPI
Thai Tran, O.D.
- Optometrist
- Costa Mesa, CA
National Provider Identifier
1669751095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14289TLG
- Practice address
- 1500 Adams Ave Ste 102
Costa Mesa, CA 92626-3864 - Phone
- (714) 200-3629
- NPI assigned
- Aug 16, 2011
- Last updated
- Apr 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14289TLG | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 14289TLG | CA | |
| Pediatric Optometrist | 152WP0200X | 14289TLG | CA |
Addresses
Primary practice location
1500 Adams Ave Ste 102
Costa Mesa, CA 92626-3864
Mailing address
1500 Adams Ave Ste 102
Costa Mesa, CA 92626-3864
Phone (714) 617-5030
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1500 Adams Ave
Suite 102
Costa Mesa, CA 92626-3864
Phone (714) 617-5030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14289TLG | CA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thai Tran Optometry Corporation | Optometrist | Current | Accepting new patients |
Locations
1500 Adams Ave
Ste 102
Costa Mesa, CA 92626
Phone (714) 200-3629
Organizations & group practices 1
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": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1669751095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ADAMS AVE STE 102",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263864",
"telephone_number": "714-617-5030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 ADAMS AVE STE 102",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263864",
"telephone_number": "714-200-3629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "THAI",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-16",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14289TLG",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "14289TLG",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "14289TLG",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.