Active NPI
Xiaoming Gao, PT
- Physical Therapist
- Middletown, NY
National Provider Identifier
1366743874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020441
- Practice address
- 14 Jason Place
Suite 201
Middletown, NY 10940 - Phone
- (845) 800-5118
- Fax
- (845) 625-1735
- NPI assigned
- Nov 15, 2010
- Last updated
- May 5, 2022
- Sex
- Male
- 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 | 020441 | NY | Primary |
Addresses
Primary practice location
14 Jason Place
Suite 201
Middletown, NY 10940
Mailing address
14 Jason Place
Suite 201
Middletown, NY 10940
Phone (845) 800-5118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14 Jason PL
Suite 201
Middletown, NY 10940-1909
Phone (845) 800-5118
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020441 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Medical Center, Inc | Current | Accepting new patients | |
| Serene Feng Acupuncture PC | Current | Accepting new patients | |
| Phoenix Care LLC | Current | Accepting new patients |
Locations
14 Jason Pl
Ste 201
Middletown, NY 10940
Phone (845) 513-6616
14 Jason Pl
Unit 201
Middletown, NY 10940
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HCIJCD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Middletown, NY
- NPI 1215593611
-
- Health Service Clinic/Center
- Flushing, NY
- NPI 1821819368
-
- Health Service Clinic/Center
- Flushing, NY
- NPI 1306536065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1366743874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 JASON PLACE",
"address_2": "SUITE 201",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "10940",
"telephone_number": "845-800-5118",
"fax_number": "845-625-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 JASON PLACE",
"address_2": "SUITE 201",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "10940",
"telephone_number": "845-800-5118",
"fax_number": "845-625-1735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAO",
"first_name": "XIAOMING",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2022-05-05",
"certification_date": "2022-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.