NPIMap

Individual provider Active NPI

Timothy Tran, M.D.

  • Urology Physician
  • New London, CT
National Provider Identifier
1720371818
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
62171 Issued in CT
Practice address
365 Montauk Avenue
Faire Harbour Building, 2ND FL, Suite 2.013
New London, CT 06320
Phone
(844) 817-9171
Fax
(203) 737-8035
NPI assigned
May 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD15933 RI
Urology Physician 208800000X 62171 CT Primary

Addresses

Primary practice location

365 Montauk Avenue
Faire Harbour Building, 2ND FL, Suite 2.013
New London, CT 06320

Mailing address

PO Box 208058
New Haven, CT 06520-8058
Phone (203) 737-7652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123003546 CT Practitioner - Urology 1759507536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albany Medical College of Union University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15933RIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jan 1, 2019 Accepting new patients
Yale University CurrentSince Jan 1, 2019 Accepting new patients
Northeast Medical Group, Inc. Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

365 Montauk Ave
Bldg 2ND
New London, CT 06320
Phone (844) 817-9171

365 Montauk Ave
Fl 2
New London, CT 06320
Phone (203) 285-5279

Interoperability endpoints

  • Direct secure messaging: ttran414381@direct.ynhh.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1720371818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208058",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208058",
            "telephone_number": "203-737-7652",
            "fax_number": "203-785-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVENUE",
            "address_2": "FAIRE HARBOUR BUILDING, 2ND FL, SUITE 2.013",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "844-817-9171",
            "fax_number": "203-737-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "RI",
            "license": "MD15933",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "62171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.