Organization Active NPI

Du Tao Internal Medicine PLLC

  • Primary Care Clinic/Center
  • Flushing, NY
National Provider Identifier
1558255083
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DU TAO INTERNAL MEDICINE PLLC
Practice address
13625 Maple Ave Ste 210
Flushing, NY 11355-3892
Phone
(203) 391-4853
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Dr. Tao Du, MDNPI 1376704916
Title
Owner
Phone
(203) 391-4853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

13625 Maple Ave Ste 210
Flushing, NY 11355-3892

Mailing address

4 Dandy Dr
Cos Cob, CT 06807-2203
Phone (203) 391-4853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250624003440 NY Part B Supplier - Clinic/Group Practice 2567974645 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

13625 Maple Ave
Ste 210
Flushing, NY 11355
Phone (203) 391-4853

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1558255083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DANDY DR",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072203",
            "telephone_number": "203-391-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 MAPLE AVE STE 210",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553892",
            "telephone_number": "203-391-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DU TAO INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-07",
        "status": "A",
        "authorized_official_last_name": "DU",
        "authorized_official_first_name": "TAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-391-4853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.