Individual provider Active NPI

Jian Zhao, M.D.

  • Anesthesiology Physician
  • Amsterdam, NY
National Provider Identifier
1427164219
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2344731 Issued in NY
Practice address
178 Clizbe Ave
Amsterdam, NY 12010-7520
Phone
(518) 843-8745
Fax
(518) 842-9633
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2344731 NY Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 2344731 NY

Addresses

Primary practice location

178 Clizbe Ave
Amsterdam, NY 12010-7520

Mailing address

178 Clizbe Ave
Amsterdam, NY 12010-7520
Phone (518) 843-8745

Other identifiers 3

IdentifierTypeStateIssuer
2623229MedicaidNY
10095329OtherNYCDPHP
4141638OtherNYMVP

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000545 NY Practitioner - Anesthesiology 8921057878 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedation Vacation Perioperative Medicine PLLCGroup PAC ID 1759658594, 86 clinicians

Practice addresses (Care Compare)

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone (718) 222-5999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2344731NYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynbrook Anesthesia Services, PC Anesthesiology CurrentSince Jun 7, 2021 Accepting new patients
Warwick Anesthesia Group LLC Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Jul 12, 2024 Accepting new patients
Centurion Midtown Anesthesia PLLC Anesthesiology CurrentSince Jan 31, 2025 Accepting new patients
Warwick Anesthesia PC Pain Medicine Past Accepting new patients

Locations

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

11129 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-8900

8745 Lake Street Rd
Le Roy, NY 14482
Phone (585) 267-7570

4604 31st Ave
Long Island City, NY 11103
Phone (718) 545-2100

305 E 47th St
New York, NY 10017
Phone (212) 203-8744

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

15 Maple Ave
Warwick, NY 10990
Phone (845) 986-2224

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1427164219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 CLIZBE AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-843-8745",
            "fax_number": "518-842-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 CLIZBE AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-843-8745",
            "fax_number": "518-842-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "JIAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "2344731",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "2344731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2623229",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10095329",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "4141638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.