Individual provider Active NPI

Raisa Gao, M.D.

  • Gynecology Physician
  • New York, NY
National Provider Identifier
1447407549
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
265535 Issued in NY
Practice address
622 W 168TH St PH 16
New York, NY 10032-3720
Phone
(913) 907-4322
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 265535 NY Primary

Addresses

Primary practice location

622 W 168TH St PH 16
New York, NY 10032-3720

Mailing address

200 W 67TH St
27H
New York, NY 10023-7340
Phone (913) 907-4322

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
I20120803000002 NY Practitioner - Obstetrics/Gynecology 0648426833 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Missouri, Columbia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

752 Park Ave
Huntington, NY 11743-3900
Phone (631) 470-8940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265535NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2015 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 15, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2015 Accepting new patients
Huntington Hospital Dolan Family Health Center CurrentSince Apr 2, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 8, 2019 Accepting new patients
Huntington Hospital Association Past Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

777 Larkfield Rd
Commack, NY 11725
Phone (631) 635-5100

752 Park Ave
Huntington, NY 11743
Phone (631) 271-9017

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

1572 New York Ave
Huntington Station, NY 11746
Phone (631) 425-5250

1176 5th Ave
Fl 2
New York, NY 10029

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 2
New York, NY 10029
Phone (212) 241-6551

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: raisagao@nslijmedgr.allscriptsdirect.net

Organizations & group practices 7

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1447407549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 67TH ST",
            "address_2": "27H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237340",
            "telephone_number": "913-907-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST PH 16",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "913-907-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "RAISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "265535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.