Individual provider Active NPI

Yongpeng Gu, M.D.

  • Urology Physician
  • Flushing, NY
National Provider Identifier
1629416664
Registry record updated Sep 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
270433 Issued in NY
Practice address
13668 Roosevelt Ave Ste 4C
Flushing, NY 11354-5510
Phone
(917) 563-1697
Fax
(917) 563-1804
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 270433 NY Primary

Addresses

Primary practice location

13668 Roosevelt Ave Ste 4C
Flushing, NY 11354-5510

Mailing address

83 Somerset Dr S
Great Neck, NY 11020-1821
Phone (917) 563-1697

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
I20140203000284 NY Practitioner - Urology 9436388907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13668 Roosevelt Ave
Suite 4C
Flushing, NY 11354-5510
Phone (917) 563-1697

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270433NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gu & Gao Medical PLLC CurrentSince Feb 8, 2016 Accepting new patients
Weiyi Gao Medical PLLC CurrentSince Sep 29, 2019 Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

13668 Roosevelt Ave
Ste 4C
Flushing, NY 11354
Phone (646) 345-1263

Networks

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

Interoperability endpoints

  • Direct secure messaging: yog9015@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569024000000",
    "number": "1629416664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SOMERSET DR S",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110201821",
            "telephone_number": "917-563-1697",
            "fax_number": "917-563-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13668 ROOSEVELT AVE STE 4C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545510",
            "telephone_number": "917-563-1697",
            "fax_number": "917-563-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GU",
        "first_name": "YONGPENG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2019-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "270433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.