Individual provider Active NPI

Xingong Gao, LAC PT DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1013998962
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013918 1 Issued in NY
Practice address
401 Broadway
Ste 709
New York, NY 10013-3018
Phone
(212) 625-9290
Fax
(212) 925-3101
NPI assigned
Nov 8, 2005
Last updated
Jul 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 002222 1 NY
Physical Therapist 225100000X 013918 1 NY Primary

Addresses

Primary practice location

401 Broadway
Ste 709
New York, NY 10013-3018

Mailing address

401 Broadway
Ste 709
New York, NY 10013-3018
Phone (212) 625-9290

Other names 1

  • Greg Xingong Gao Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100709000360 NY Practitioner - Physical Therapist in Private Practice 5092847012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 N Central Ave
Suite 240
Hartsdale, NY 10530-1938
Phone (914) 421-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013918NYMDSocial Worker
002222 1NYMDAcupuncturist
013918 1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Gao Physical Therapy PC Physical Therapist CurrentSince Feb 1, 2010 Accepting new patients
Westchester Gao Physical Therapy Current Accepting new patients
Wensong Li Medicine PC CurrentSince Sep 19, 2015 Accepting new patients
New York Gao Physical Therapy PC Acupuncturist CurrentSince Jan 26, 1998 Accepting new patients
Holt Chiropractic Offices, P.C. Past Accepting new patients

Locations

13620 Maple Ave
Ste 601
Flushing, NY 11355
Phone (718) 886-8562

13625 Maple Ave
Ste 201
Flushing, NY 11355
Phone (718) 886-8562

4235 Main St
Ste 3A
Flushing, NY 11355
Phone (718) 630-7616

111 N Central Ave
Ste 240
Hartsdale, NY 10530
Phone (914) 421-1600

139 Centre St
Ste 708
New York, NY 10013
Phone (212) 625-9290

401 Broadway
Ste 1808
New York, NY 10013
Phone (212) 625-9290

401 Broadway
Ste 709
New York, NY 10013
Phone (212) 625-9290

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1013998962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BROADWAY",
            "address_2": "STE 709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133018",
            "telephone_number": "212-625-9290",
            "fax_number": "212-925-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BROADWAY",
            "address_2": "STE 709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133018",
            "telephone_number": "212-625-9290",
            "fax_number": "212-925-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "XINGONG",
        "credential": "LAC  PT  DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "002222 1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013918 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREG",
            "last_name": "GAO",
            "middle_name": "XINGONG",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.