Individual provider Active NPI

Teng Jiao Peng Zhao, MD

  • Vascular Neurology Physician
  • Gainesville, FL
National Provider Identifier
1093247827
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
ME161325 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 273-5550
Fax
(352) 273-5575
NPI assigned
Mar 30, 2017
Last updated
Jun 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 69102 CT
Neurology Physician 2084N0400X ME161325 FL
Vascular Neurology Physician 2084V0102X ME161325 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 100236
Gainesville, FL 32610-0236
Phone (352) 273-5550

Other practice location 1

20 York St
New Haven, CT 06510
Phone (203) 688-4242

Other practice location 2

3009 SW Williston Rd
Gainesville, FL 32608-3928
Phone (352) 294-5400

Other practice location 3

1505 SW Archer Rd
Gainesville, FL 32608-1134
Phone (352) 265-8408

Other practice location 4

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Other names 1

  • Teng Jiao Peng Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230412001850 FL Practitioner - Neurology 6002180049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1041 Dunlawon Ave
Port Orange, FL 32127-7968
Phone (386) 425-4700

1505 SW Archer Rd
Gainesville, FL 32608-1134

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

303 N Clyde Morris Blvd
Halifax Health
Daytona Beach, FL 32114-2709
Phone (386) 425-4000

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161325FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince May 1, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 1, 2023 Accepting new patients

Locations

1505 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-8408

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

3009 SW Williston Rd
Gainesville, FL 32608
Phone (352) 294-5400

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tpengzhao396353@direct.ynhh.org
  • Direct secure messaging: tpengzhao624931@direct.shands.ufl.edu

Organizations & group practices 2

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1093247827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100236",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100236",
            "telephone_number": "352-273-5550",
            "fax_number": "352-273-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5550",
            "fax_number": "352-273-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06510",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3009 SW Williston Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326083928",
            "country_code": "US",
            "telephone_number": "352-294-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081134",
            "country_code": "US",
            "telephone_number": "352-265-8408",
            "fax_number": "352-265-8409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENG ZHAO",
        "first_name": "TENG",
        "middle_name": "JIAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "69102",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME161325",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "FL",
            "license": "ME161325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TENG",
            "last_name": "PENG",
            "middle_name": "JIAO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.