Active NPI
Tram Le Pham, O.D
- Optometrist
- San Jose, CA
National Provider Identifier
1750468112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11732 T
- Practice address
- 265 Meridian Ave
Ste 6
San Jose, CA 95126-2906 - Phone
- (408) 995-6282
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11732 T | CA | Primary |
Addresses
Primary practice location
265 Meridian Ave
Ste 6
San Jose, CA 95126-2906
Mailing address
7295 Forsum Rd
San Jose, CA 95138-1903
Phone (408) 892-0319
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA1732 | Other | CA | EYEMED VISION |
| 13769 | Other | CA | MEDICAL EYE SERVICES |
| 16257 | Other | CA | SPECTERA VISION |
| 1608836 | Other | CA | CLARITY VISION |
| 50620 | Other | CA | SAFEGUARD VISION |
| SD0117320 | Medicaid | CA | |
| SD0117321 | Medicaid | CA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100310000689 | CA | Practitioner - Optometry | 1759426059 | Practice locations: San Jose, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11732 T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750468112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7295 FORSUM RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951381903",
"telephone_number": "408-892-0319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 MERIDIAN AVE",
"address_2": "STE 6",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951262906",
"telephone_number": "408-995-6282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRAM",
"middle_name": "LE",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11732 T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED VISION",
"identifier": "CA1732",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES",
"identifier": "13769",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA VISION",
"identifier": "16257",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLARITY VISION",
"identifier": "1608836",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAFEGUARD VISION",
"identifier": "50620",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0117320",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0117321",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.