Individual provider Active NPI

Lichieh Pao, DPT

  • Physical Therapist
  • Rego Park, NY
National Provider Identifier
1043904162
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050219 Issued in NY
Practice address
6541 Wetherole St
Rego Park, NY 11374-4753
Phone
(917) 862-7787
NPI assigned
Jun 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 050219 NY Primary

Addresses

Primary practice location

6541 Wetherole St
Rego Park, NY 11374-4753

Mailing address

6541 Wetherole St
Rego Park, NY 11374-4753
Phone (917) 862-7787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231002000159 NJ Practitioner - Physical Therapist in Private Practice 7214381805 Reassigns benefits to 1 organization
I20240208001323 NY Practitioner - Physical Therapist in Private Practice 7214381805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Care Physical Therapy and Sports Medicine PCGroup PAC ID 3678875978, 7 clinicians

Practice addresses (Care Compare)

25503 Union Tpke
Glen Oaks, NY 11004-1223
Phone (718) 928-2790

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

4801 Broadway
Union City, NJ 07087-6516
Phone (201) 751-5000

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2024 Accepting new patients
Total Care Physical Therapy & Sports Medicine PC Physical Therapist CurrentSince Jul 21, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

4801 Broadway
Union City, NJ 07087
Phone (201) 543-1668

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1043904162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6541 WETHEROLE ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744753",
            "telephone_number": "917-862-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6541 WETHEROLE ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744753",
            "telephone_number": "917-862-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAO",
        "first_name": "LICHIEH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.