Active NPI
Jingyun Gao
- Dermatology Physician
- Gaithersburg, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- D0085023
- Practice address
- 655 Watkins Mill Rd
Gaithersburg, MD 20879-3301 - Phone
- (844) 549-0597
- NPI assigned
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A179320 | CA | |
| Internal Medicine Physician | 207R00000X | 125064585 | IL | |
| Dermatology Physician | 207N00000X | D0085023 | MD | Primary |
Addresses
Primary practice location
655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Mailing address
1515 N Vermont Ave
Los Angeles, CA 90027-5337
Phone (800) 954-8000
Other practice location 1
5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465
Phone (773) 702-6840
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Duke University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1515 N Vermont Ave
Los Angeles, CA 90027-5337
Phone (323) 783-4011
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A179320 | CA | MD | Dermatology Physician |
| D0085023 | MD | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Internal Medicine | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
1515 N Vermont Ave
Los Angeles, CA 90027
Phone (323) 783-5906
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000
700 2nd St NE
Washington, DC 20002
Phone (202) 346-3000
655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
Organizations & group practices 6
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC, Internal Medicine
-
- Health Maintenance Organization
- Gaithersburg, MD
- NPI 1831471713
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
-
- Health Maintenance Organization
- Oxnard, CA
- NPI 1275756652
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1598178329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275337",
"telephone_number": "800-954-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 WATKINS MILL RD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793301",
"telephone_number": "844-549-0597"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave Ste Mc7082",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371465",
"country_code": "US",
"telephone_number": "773-702-6840",
"fax_number": "773-702-2230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAO",
"first_name": "JINGYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-10",
"last_updated": "2022-07-25",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A179320",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125064585",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MD",
"license": "D0085023",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4733 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.