Individual provider Active NPI

Tracy Phuong Tram, M.D.

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1922103191
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A61549 Issued in CA
Practice address
2360 McKee Rd
Suite 1
San Jose, CA 95116-1618
Phone
(408) 926-2420
Fax
(408) 926-2422
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A61549 CA Primary

Addresses

Primary practice location

2360 McKee Rd
Suite 1
San Jose, CA 95116-1618

Mailing address

2360 McKee Rd
Suite 1
San Jose, CA 95116-1618
Phone (408) 926-2420

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000046 CA Practitioner - Internal Medicine 4183777410 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2360 McKee Rd
San Jose, CA 95116-1618
Phone (408) 926-2420

Hospital & facility affiliations

  • South Springs Home Health Care Home health agency, San Jose, CA, CCN 059620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1922103191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MCKEE RD",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161618",
            "telephone_number": "408-926-2420",
            "fax_number": "408-926-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MCKEE RD",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161618",
            "telephone_number": "408-926-2420",
            "fax_number": "408-926-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAM",
        "first_name": "TRACY",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A61549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.