Individual provider Active NPI

Jun Xu, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Riverside, CT
National Provider Identifier
1386671642
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
038206 Issued in CT
Practice address
1171 E Putnam Ave
Riverside, CT 06878-1426
Phone
(203) 637-7720
Fax
(203) 637-2693
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 038206 CT Primary

Addresses

Primary practice location

1171 E Putnam Ave
Riverside, CT 06878-1426

Mailing address

1171 E Putnam Ave
Riverside, CT 06878-1426
Phone (203) 637-7720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120126000335 CT Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 3577730977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Group practices
Rehabilitation Medicine and Acupuncture Center MD LLCGroup PAC ID 8325215726, 2 clinicians

Practice addresses (Care Compare)

1171 E Putnam Ave
Riverside, CT 06878-1426

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038206CTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Medicine & Acupuncture Center MD LLC Physical Medicine & Rehabilitation CurrentSince Sep 1, 2000 Accepting new patients

Locations

1171 E Putnam Ave
Ste 2
Riverside, CT 06878
Phone (203) 637-1111

1171 E Putnam Ave
Riverside, CT 06878
Phone (203) 637-1111

1171 E Putnam Ave
Ste 1
Riverside, CT 06878
Phone (203) 637-7720

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1386671642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 E PUTNAM AVE",
            "city": "RIVERSIDE",
            "state": "CT",
            "postal_code": "068781426",
            "telephone_number": "203-637-7720",
            "fax_number": "203-637-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 E PUTNAM AVE",
            "city": "RIVERSIDE",
            "state": "CT",
            "postal_code": "068781426",
            "telephone_number": "203-637-7720",
            "fax_number": "203-637-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "JUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "038206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CT

Sources for this page

Verify at the official NPI Registry.