Individual provider Active NPI

Xiaoming Gao, PT

  • Physical Therapist
  • Middletown, NY
National Provider Identifier
1366743874
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020441 Issued in NY
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20220429000553 NY Practitioner - Physical Therapist in Private Practice 4880081470 Reassigns benefits to 3 organizations

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
Northern Medical Center, Inc.Group PAC ID 5597194928, 4 clinicians

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

LicenseStateTypeSpecialty
020441NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Medical Center, Inc CurrentSince Apr 20, 2022 Accepting new patients
Serene Feng Acupuncture PC CurrentSince Jul 22, 2024 Accepting new patients
Phoenix Care LLC CurrentSince Oct 1, 2024 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.