Active NPI
Jinyuan Xiao, PT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1265614515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 013003-1
- Practice address
- 2113 E 17TH St
Brooklyn, NY 11229-4403 - Phone
- (718) 998-0486
- Fax
- (718) 998-2095
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 013003-1 | NY | Primary |
Addresses
Primary practice location
2113 E 17TH St
Brooklyn, NY 11229-4403
Mailing address
2113 E 17TH St
Brooklyn, NY 11229-4403
Phone (718) 998-0486
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100428000168 | NY | Practitioner - Physical Therapist in Private Practice | 9830226638 | Practice locations: Brooklyn, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2113 E 17TH St
Brooklyn, NY 11229-4403
Phone (718) 998-6247
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013003-1 | NY | MD | Physical Therapist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1265614515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 E 17TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294403",
"telephone_number": "718-998-0486",
"fax_number": "718-998-2095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2113 E 17TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294403",
"telephone_number": "718-998-0486",
"fax_number": "718-998-2095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XIAO",
"first_name": "JINYUAN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "013003-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.