Thao Nguyen Tran, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

44790-20 Issued in WI

Practice address

2120 82ND St
Kenosha, WI 53143-1612

Phone

(262) 842-2358

Fax

(888) 959-8367

NPI assigned

Feb 23, 2006

Last updated

Jun 19, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Thao Kimphuong Nguyen Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

Baylor College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thao Nguyen Tran MD SC

  • Ophthalmology Physician
  • Kenosha, WI
  • NPI 1639509789

  IL

  Medicare reassignment NPD Authorized official

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

• Advocate Condell Medical Center

  dba Advocate Condell Imaging Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  dba Advocate Condell Medical Center Grays Lake

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1891761524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 82ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431612",
            "telephone_number": "262-842-2358",
            "fax_number": "888-959-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 82ND ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431612",
            "telephone_number": "262-842-2358",
            "fax_number": "888-959-8367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7201 Green Bay Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531423532",
            "country_code": "US",
            "telephone_number": "262-842-2358",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1641 N Milwaukee Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600481350",
            "country_code": "US",
            "telephone_number": "262-842-2358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THAO",
        "middle_name": "NGUYEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "44790-20",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036099127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34243100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "epic link aurora",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1641 N Milwaukee Ave Ste 10",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600481350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttran@edl.ecldirect.net",
            "affiliation": "N",
            "endpointDescription": "EMR direct message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7201 Green Bay Rd Ste C",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531423532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "epic link aurora",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1641 N Milwaukee Ave Ste 10",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600481350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "NGUYEN",
            "middle_name": "KIMPHUONG",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ophthalmology Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.

Verify at the official NPI Registry.