NGUYET-ANH THI TRAN MD
NPI 1447442355
Internal Medicine - Rheumatology in Madison, WI

NPI Status: Active since August 14, 2007

Contact Information

1821 S STOUGHTON RD
MADISON, WI
ZIP 53716
Phone: (608) 260-6000
Fax: (608) 260-6855

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  • Individual
  • Female
  • Years of Experience 22
  • Internal Medicine
  • Rheumatology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NGUYET-ANH TRAN

This page provides the complete NPI Profile along with additional information for Nguyet-anh Tran, an internist established in Madison, Wisconsin with a medical specialization in Internal Medicine, focusing in rheumatology and more than 22 years of experience. She graduated from University Of Tennessee, Hsc, College Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1447442355 assigned on August 2007. The practitioner's primary taxonomy code is 207RR0500X with license number 75456-20 (WI). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1447442355
Provider Name
NGUYET-ANH THI TRAN MD
Gender
Female
Entity Type
Individual
Location Address
1821 S STOUGHTON RD MADISON, WI 53716
Location Phone
(608) 260-6000
Location Fax
(608) 260-6855
Mailing Address
1821 S STOUGHTON RD MADISON, WI 53716
Mailing Phone
(608) 260-6000
Mailing Fax
(608) 260-6855
Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
08-14-2007
Last Update Date
09-20-2022
Code Navigator

An internist like Nguyet-anh Tran is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Rheumatology

Taxonomy Code
207RR0500X
Type
Allopathic & Osteopathic Physicians
License No.
75456-20
License State
WI
Taxonomy Description
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207RR0500XAllopathic & Osteopathic Physicians

Internal Medicine
Rheumatology

47558 (CO)
2207RR0500XAllopathic & Osteopathic Physicians

Internal Medicine
Rheumatology

MD00048175 (WA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1447442355MEDICAID (05)WI 

Medicare Participation & PECOS Enrollment Status

Nguyet-anh Tran is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Nguyet-anh Tran is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6608922216

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210726003548

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 21 times for 16 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 20 times for 16 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 66 times for 57 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 450 times for 281 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 37 times for 30 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 13 times for 13 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 38 times for 38 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.92 for a new patient copayment and $23.85 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53716 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $123.69
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $30.92
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nguyet-anh Tran is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SSM HEALTH ST CLARE HOSPITAL - BARABOO707 14TH ST
BARABOO, WI 53913
(608) 356-1400Acute Care Hospitals
SSM HEALTH ST MARY'S HOSPITAL - MADISON700 SOUTH PARK ST
MADISON, WI 53715
(608) 251-6100Acute Care Hospitals
SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE3400 EAST RACINE STREET
JANESVILLE, WI 53546
(608) 373-8000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1447442355, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
4
Doubled → 8
Pos 4
7
Unchanged
Pos 5
4
Doubled → 8
Pos 6
4
Unchanged
Pos 7
2
Doubled → 4
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 2 → 4 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 8 + 7 + 8 + 4 + 4 + 3 + 1 + 0 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1447442355.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Social Worker (Clinical)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Social Worker (Clinical)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Social Worker (Clinical)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Physician Assistant (Medical)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Nurse Practitioner
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Internal Medicine (Cardiovascular Disease)
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Family Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Family Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Internal Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Obstetrics & Gynecology
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Internal Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Internal Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Obstetrics & Gynecology
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Psychologist
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Surgery
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Emergency Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Emergency Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Emergency Medicine
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716
Orthopaedic Surgery
1821 S STOUGHTON RD, DEAN MEDICAL CENTER
MADISON, WI 53716

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447442355, enumerated as an "individual" on August 14, 2007.

The provider is located at 1821 S STOUGHTON RD MADISON, WI 53716 and the phone number is (608) 260-6000.

Internal Medicine with taxonomy code 207RR0500X and a focus in Rheumatology.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.

Nguyet-anh Tran is affiliated with: SSM HEALTH ST CLARE HOSPITAL - BARABOO, SSM HEALTH ST MARY'S HOSPITAL - MADISON and SSM HEALTH ST MARY'S HOSPITAL - JANESVILLE.