Individual provider Active NPI

John Gao

  • Adult Health Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1447666888
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307182 Issued in NY
Practice address
14456 25TH Road
Flushing, NY 11354
Phone
(646) 239-5838
NPI assigned
Jul 7, 2014
Last updated
Jan 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307182 NY Primary
Registered Nurse 163W00000X 632371 NY

Addresses

Primary practice location

14456 25TH Road
Flushing, NY 11354

Mailing address

14456 25TH Road
Flushing, NY 11354
Phone (646) 239-5838

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416000516 NY Practitioner - Nurse Practitioner 5092033324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
632371NYMDRegistered Nurse
F307182NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2020 Accepting new patients
New York University CurrentSince Aug 1, 2020 Accepting new patients
Medical Therapy of New York, PLLC Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

Networks

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

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1447666888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14456 25TH ROAD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "646-239-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14456 25TH ROAD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "646-239-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307182",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "632371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.