Active NPI
Gin Sou Ngo, PT
- Physical Therapist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2023009642
- Practice address
- 4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108-2212 - Phone
- (314) 286-1940
- Fax
- (314) 286-1473
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2023009642 | MO | Primary |
Addresses
Primary practice location
4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108-2212
Mailing address
PO Box 60352
Saint Louis, MO 63160-0352
Phone (314) 286-1940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480128523 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
1614 W Central Rd
Suite 200
Arlington Heights, IL 60005-2453
Phone (847) 481-6077
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Wellness Group LLC | Current | Accepting new patients | |
| Washington University | Physical Therapist | Current | Accepting new patients |
| Washington University | Current | Accepting new patients |
Locations
1614 W Central Rd
Ste 200
Arlington Hts, IL 60005
Phone (847) 481-6077
4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108
4444 Forest Park Ave
#8502
Saint Louis, MO 63108
Phone (314) 286-1430
660 S Euclid Ave
Saint Louis, MO 63110
4444 Forest Park Ave
Ste 1101
Saint Louis, MO 63108
Phone (314) 286-1440
Interoperability endpoints
- https://api.platform.athenahealth.com/22368/brand/1/csg/1/fhir/r4
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.
-
- Physical Therapy Clinic/Center
- Arlington Heights, IL
- NPI 1619372893
-
- Physical Therapy Clinic/Center
- Saint Louis, MO
- NPI 1922048420
Physical Therapist
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1083344329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60352",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631600352",
"telephone_number": "314-286-1940",
"fax_number": "314-286-1473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 FOREST PARK AVE",
"address_2": "STE 1210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082212",
"telephone_number": "314-286-1940",
"fax_number": "314-286-1473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO",
"first_name": "GIN",
"middle_name": "SOU",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2024-04-25",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2023009642",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "480128523",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "4444 Forest Park Ave",
"address_2": "Ste 1210",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631082212",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.