Individual provider Active NPI

Susan Tran, D.O.

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1962752600
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12499 Issued in CA
Practice address
1569 Lexann Ave
Suite 128
San Jose, CA 95121-1794
Phone
(408) 274-1654
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A12499 CA Primary

Addresses

Primary practice location

1569 Lexann Ave
Suite 128
San Jose, CA 95121-1794

Mailing address

1569 Lexann Ave
Suite 128
San Jose, CA 95121-1794

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
I20140924002627 CA Practitioner - Family Practice 6305066390 Reassigns benefits to 1 organization
Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Western University of Health Sciences College of Dental Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

14251 Winchester Blvd
Suite 200
Los Gatos, CA 95032-1811
Phone (408) 426-5540

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380
  • El Camino Health Hospital, Mountain View, CA, CCN 050308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12499CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Mar 1, 2016 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

14251 Winchester Blvd
#200
Los Gatos, CA 95032
Phone (408) 426-5540

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.

Hospital & facility affiliations 11

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1962752600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "SUITE 128",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "SUITE 128",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794",
            "telephone_number": "408-274-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "SUSAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.