Individual provider Active NPI

Peter Tran, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1922416403
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8482T Issued in TX
Practice address
2800 S Ih 35 Ste 126
Austin, TX 78704-5700
Phone
(512) 462-0020
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8482T TX Primary

Addresses

Primary practice location

2800 S Ih 35 Ste 126
Austin, TX 78704-5700

Mailing address

8211 Shenandoah Dr
Austin, TX 78753-5736
Phone (479) 739-6857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115003277 TX Practitioner - Optometry 0840571691 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8482TXMDAddiction (Substance Use Disorder) Counselor
8482TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Berg En Dal PLLC Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Berg En Dal PLLC Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Third Eye PLLC Optometrist CurrentSince Sep 27, 2023 Accepting new patients

Locations

3601 W William Cannon Dr
Ste 150
Austin, TX 78749
Phone (512) 441-8924

2800 S Interstate 35
Ste 126
Austin, TX 78704
Phone (512) 462-0020

2407 S Congress Ave
Ste 100A
Austin, TX 78704
Phone (512) 233-6879

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1922416403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 SHENANDOAH DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787535736",
            "telephone_number": "479-739-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S IH 35 STE 126",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045700",
            "telephone_number": "512-462-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8482T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.