Active NPI
Bao Tran
- Physician Assistant
- Moorhead, MN
National Provider Identifier
1700583267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14361
- Practice address
- 2405 8TH St S Ste 200
Moorhead, MN 56560-4200 - Phone
- (218) 331-4866
- NPI assigned
- Feb 14, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14361 | MN | Primary |
Addresses
Primary practice location
2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Mailing address
2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1811 Weir Dr
Suite 270
Woodbury, MN 55125-6741
Phone 6517149646651714
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Current | Accepting new patients |
Locations
2405 8th St S
Ste 200
Moorhead, MN 56560
Phone (218) 331-4866
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1811 Weir Dr
Ste 270
Woodbury, MN 55125
Phone (651) 243-6087
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.
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- New Brighton, MN
- NPI 1467549220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1700583267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2405 8TH ST S STE 200",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565604200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2405 8TH ST S STE 200",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565604200",
"telephone_number": "218-331-4866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "BAO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-14",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "14361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.