Individual provider Active NPI

Tri Tu Tran, PA-C

  • Surgical Physician Assistant
  • The Villages, FL
National Provider Identifier
1780658500
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101733 Issued in FL
Practice address
1050 Old Camp Rd
Suite 202
The Villages, FL 32162-1762
Phone
(352) 259-5960
Fax
(352) 750-1854
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101733 FL
Surgical Physician Assistant 363AS0400X PA9101733 FL Primary
Medical Physician Assistant 363AM0700X PA9101733 FL

Addresses

Primary practice location

1050 Old Camp Rd
Suite 202
The Villages, FL 32162-1762

Mailing address

1050 Old Camp Rd
Suite 202
The Villages, FL 32162-1762
Phone (352) 259-5960

Other identifiers 1

IdentifierTypeStateIssuer
291141800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050914000764 FL Practitioner - Physician Assistant 4486687084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliant Dermatology PAGroup PAC ID 9436305273, 12 clinicians

Practice addresses (Care Compare)

121 Lagrande Blvd
Lady Lake, FL 32159-1342
Phone (352) 547-3373

2105 SW 20TH PL
Ocala, FL 34471-7734
Phone (352) 622-4251

2111 SW 20TH PL
Ocala, FL 34471-7734
Phone (352) 622-4251

8620 A E County Rd
Suite 466
The Villages, FL 32162-3670
Phone (352) 399-7295

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.36 of 100Reported as group
Quality
55.49
Promoting interoperability
100
Improvement activities
40
Cost
52.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Vein Center LLC Physician Assistant Current Accepting new patients
Cardiovascular Institute of Central Florida, LLC CurrentSince Nov 3, 2022 Accepting new patients
Osprey Emergency Physicians LLC Past Accepting new patients
Orlando Carenow Urgent Care LLC Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Institute of Cardiovascular Excellence PLLC Past Accepting new patients
Creekside Dermatology PA Past Accepting new patients

Locations

121 Lagrande Blvd
Lady Lake, FL 32159
Phone (352) 259-5960

2111 SW 20th Pl
Ocala, FL 34471
Phone (352) 547-3399

10000 W Colonial Dr
Ste 281
Ocoee, FL 34761
Phone (321) 841-3467

10000 W Colonial Dr
Ste 495
Ocoee, FL 34761
Phone (407) 293-5944

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

1050 Old Camp Rd
Ste 202
The Villages, FL 32162
Phone (352) 259-5960

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: tri.tran.1@29679.direct.athenahealth.com
  • Direct secure messaging: tomt@alliantderm.emadirect.md

Organizations & group practices 10

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 2

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1780658500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "address_2": "SUITE 202",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-259-5960",
            "fax_number": "352-750-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "address_2": "SUITE 202",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-259-5960",
            "fax_number": "352-750-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TRI",
        "middle_name": "TU",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101733",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101733",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291141800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.