Dr Kelly Tran, is a medicare enrolled "Physical Therapist" physician in Willow Park, Texas. His current practice location is
110 Mary Lou Dr Ste 100, Willow Park, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 945-3344.
Dr Kelly Tran is licensed to practice in Texas (license number 1332075) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558970756.
Physician's Profile
| Full Name | Dr Kelly Tran |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 110 Mary Lou Dr Ste 100, Willow Park, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558970756
- Provider Enumeration Date: 07/24/2020
- Last Update Date: 06/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759727779
- Enrollment ID: I20240313001939
Medical Identifiers
Medical identifiers for Dr Kelly Tran such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558970756 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | 1332075 (Texas) | Secondary |
| 225100000X | Physical Therapist | 1332075 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kelly Tran allows following entities to bill medicare on his behalf.
| Entity Name | Endeavor Rehab Center Inc |
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| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Entity Identifiers | NPI Number: 1760506232
PECOS PAC ID: 6800989369
Enrollment ID: O20070829000910 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly Tran is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kelly Tran,
1111 Summit Ave,
Fort Worth, TX 76102-3425
Ph: () - | Dr Kelly Tran,
110 Mary Lou Dr Ste 100,
Willow Park, TX 76087-8767
Ph: (817) 945-3344 |
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