Individual provider Active NPI

Xiaoyu Gao

  • Adult Health Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1699572156
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312188 Issued in NY
Practice address
13636 39TH Ave Ste 5
Flushing, NY 11354-5576
Phone
(917) 257-9819
NPI assigned
Mar 3, 2025
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 312188 NY Primary

Addresses

Primary practice location

13636 39TH Ave Ste 5
Flushing, NY 11354-5576

Mailing address

7133 166TH St
Fresh Meadows, NY 11365-3235
Phone (917) 257-9819

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
I20250919001540 NY Practitioner - Nurse Practitioner 3678077831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13633 37TH Ave
Suite 1C
Flushing, NY 11354-4110

13633 37TH Ave
Suite 1C
Flushing, NY 11354-4562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Medical Care, P.C. CurrentSince Aug 15, 2025 Accepting new patients

Locations

13633 37th Ave
#1
Flushing, NY 11354
Phone (718) 961-9800

Organizations & group practices 1

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": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1699572156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7133 166TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653235",
            "telephone_number": "917-257-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13636 39TH AVE STE 5",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545576",
            "telephone_number": "917-257-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "XIAOYU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.