Individual provider Active NPI

Hoa Thi Mai Tran

  • Physician Assistant
  • Branson, MO
National Provider Identifier
1912088089
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2004022194 Issued in MO
Practice address
875 E State Highway 76 Ste a
Branson, MO 65616
Phone
(417) 334-5864
Fax
(417) 334-4978
NPI assigned
Oct 17, 2006
Last updated
Jul 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2004022194 MO Primary

Addresses

Primary practice location

875 E State Highway 76 Ste a
Branson, MO 65616

Mailing address

875 E State Highway 76 Ste a
Branson, MO 65616-7511
Phone (417) 334-5864

Other identifiers 1

IdentifierTypeStateIssuer
2004022194OtherMOPHYSICIAN ASST. LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090422000662 MO Practitioner - Physician Assistant 9830247220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Branson Pulmonology and Sleep LLCGroup PAC ID 7315041472, 2 clinicians

Practice addresses (Care Compare)

875 E State Hwy 76
Suite a
Branson, MO 65616-7511
Phone (417) 334-5864

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.54 of 100Reported as group
Quality
56.59
Improvement activities
40
Cost
76.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004022194MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Organizations & group practices 2

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.

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1912088089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E STATE HIGHWAY 76 STE A",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167511",
            "telephone_number": "417-334-5864",
            "fax_number": "417-334-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E STATE HIGHWAY 76 STE A",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-334-5864",
            "fax_number": "417-334-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "HOA",
        "middle_name": "THI MAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2004022194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASST. LICENSE",
            "identifier": "2004022194",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.