Individual provider Active NPI

Gordon Guanxiong Mao, MD

  • Neurological Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1063854651
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
01085850A Issued in IN
Practice address
355 W. 16TH Street
Goodman Hall Suite 5100
Indianapolis, IN 46202
Phone
(317) 963-1300
NPI assigned
Jul 23, 2013
Last updated
Feb 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 01085850B IN
Neurological Surgery Physician 207T00000X MT2050 PA
Neurological Surgery Physician 207T00000X 01085850A IN Primary

Addresses

Primary practice location

355 W. 16TH Street
Goodman Hall Suite 5100
Indianapolis, IN 46202

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

212 Tanglewood Dr
Richmond, CA 94806-5814
Phone (510) 280-4045

Other identifiers 1

IdentifierTypeStateIssuer
MT2050OtherLICENES

Other names 1

  • Dr. Guanxiong Mao Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmao@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200727003713 MD Practitioner - Neurosurgery 7517255136 Reassigns benefits to 1 organization
I20210804001545 IN Practitioner - Neurosurgery 7517255136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion195
Laminectomy or laminotomy (partial removal of spine bones)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01085850AINMDNeurological Surgery Physician
01085850BINMDNeurological Surgery Physician
MT2050PAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2020 Accepting new patients
Johns Hopkins University Neurological Surgery CurrentSince Jul 1, 2020 Accepting new patients
University Family Physicians, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Johns Hopkins University Current Accepting new patients
Major Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

355 W 16th St
Ste 5100
Indianapolis, IN 46202
Phone (317) 963-8145

362 W 15th St
Ste 5100
Indianapolis, IN 46202

600 N Wolfe St
Baltimore, MD 21287

600 N Wolfe St
#7113
Baltimore, MD 21287
Phone (410) 955-4424

Interoperability endpoints

  • Direct secure messaging: gmao@direct.iuhealth.org
  • Direct secure messaging: gmao89173@direct.eskenazihealth.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1063854651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W. 16TH STREET",
            "address_2": "GOODMAN HALL SUITE 5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-963-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Tanglewood Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948065814",
            "country_code": "US",
            "telephone_number": "510-280-4045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAO",
        "first_name": "GORDON",
        "middle_name": "GUANXIONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01085850B",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MT2050",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01085850A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENES",
            "identifier": "MT2050",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmao@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "355 W. 16th Street",
            "address_2": "Goodman Hall Suite 5100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GUANXIONG",
            "last_name": "MAO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.