Individual provider Active NPI

Long Tran

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1902448475
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7349 Issued in MA
Practice address
830 Harrison Avenue
Moakley, Suite 3400
Boston, MA 02118
Phone
(617) 414-8060
Fax
(617) 414-8012
NPI assigned
Oct 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA7349 MA Primary

Addresses

Primary practice location

830 Harrison Avenue
Moakley, Suite 3400
Boston, MA 02118

Mailing address

801 Albany Street
FL Ground
Boston, MA 02119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210113001824 MA Practitioner - Physician Assistant 9739592676 Reassigns benefits to 4 organizations
I20240130001394 CA Practitioner - Physician Assistant 9739592676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Boston University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgeons of Orange a Medical GroupGroup PAC ID 6901705227, 116 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 634-5549

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA7349MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Sep 13, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jan 5, 2021 Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 22C
Orange, CA 92868
Phone (714) 456-5308

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#15
Boston, MA 02114
Phone (617) 724-3874

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

55 Fruit St
Boston, MA 02114

Organizations & group practices 6

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1902448475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVENUE",
            "address_2": "MOAKLEY, SUITE 3400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-8060",
            "fax_number": "617-414-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "LONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.