Individual provider Active NPI

Jolene Thu Tran

  • Physician Assistant
  • Campbell, CA
National Provider Identifier
1750992152
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59149 Issued in CA
Practice address
1580 Winchester Blvd Ste 202
Campbell, CA 95008-0519
Phone
(408) 364-7600
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA59149 CA Primary

Addresses

Primary practice location

1580 Winchester Blvd Ste 202
Campbell, CA 95008-0519

Mailing address

2811 Glauser Dr
San Jose, CA 95133-1410

Other practice location 1

554 Blossom Hill Rd
San Jose, CA 95123-3212
Phone (408) 281-2772

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210304002233 CA Practitioner - Physician Assistant 3274949938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59149CAMDGeneral Practice Dentistry
PA59149CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
California Emergency Physicians CurrentSince Apr 1, 2021 Accepting new patients
California Emergency Physicians CurrentSince Apr 1, 2021 Accepting new patients

Locations

50 E Hamilton Ave
Ste 100
Campbell, CA 95008
Phone (408) 364-7600

1580 S Winchester Blvd
Ste 202
Campbell, CA 95008
Phone (408) 364-7600

554 Blossom Hill Rd
San Jose, CA 95123
Phone (408) 281-2772

Interoperability endpoints

  • Direct secure messaging: jolene.tran@620821020676.direct.elationemr.com
  • Direct secure messaging: jtran189794@santaclaravalley.direct-ci.net

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 1

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1750992152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 GLAUSER DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951331410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 WINCHESTER BLVD STE 202",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080519",
            "telephone_number": "408-364-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 Blossom Hill Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951233212",
            "country_code": "US",
            "telephone_number": "408-281-2772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JOLENE",
        "middle_name": "THU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.