Active NPI
Grace Yu Yi Gu, M.D
- Addiction Medicine (Family Medicine) Physician
- New York, NY
National Provider Identifier
1114454899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- 307602
- Practice address
- 45 Rivington St
New York, NY 10002-1304 - Phone
- (332) 243-1000
- NPI assigned
- May 12, 2017
- 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 |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 307602 | NY | Primary |
Addresses
Primary practice location
45 Rivington St
New York, NY 10002-1304
Mailing address
45 Rivington St
New York, NY 10002-1304
Other practice location 1
23621 Main St
Carson, CA 90745-5743
Phone (310) 513-6707
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Beth Israel Medical Center | Past | Accepting new patients |
Locations
45 Rivington St
New York, NY 10002
Phone (212) 477-3100
150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119
1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
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.
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- NPI 1760227466
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- General Acute Care Hospital
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- NPI 1174689665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1114454899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 RIVINGTON ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100021304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 RIVINGTON ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100021304",
"telephone_number": "332-243-1000"
}
],
"practiceLocations": [
{
"address_1": "23621 Main St",
"address_purpose": "LOCATION",
"city": "Carson",
"state": "CA",
"postal_code": "907455743",
"country_code": "US",
"telephone_number": "310-513-6707",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GU",
"first_name": "GRACE",
"middle_name": "YU YI",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-12",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "NY",
"license": "307602",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "25825 Vermont Ave",
"city": "Harbor City",
"state": "CA",
"country_code": "US",
"postal_code": "907103518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.