Individual provider Active NPI

Keqin Gao, M.D.

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1902826019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
224136 Issued in NY
Practice address
374 Stockholm St
C/O Faculty Practice Management Suite I-37 North
Brooklyn, NY 11237-4006
Phone
(718) 960-6551
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 224136 NY Primary

Addresses

Primary practice location

374 Stockholm St
C/O Faculty Practice Management Suite I-37 North
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm St
C/O Faculty Practice Management Suite I-37 North
Brooklyn, NY 11237-4006
Phone (718) 960-6551

Other identifiers 1

IdentifierTypeStateIssuer
02285550MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224136NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Endoscopy PLLC CurrentSince Jan 1, 2016 Accepting new patients
Flushing Endoscopy Center LLC Anesthesiology CurrentSince Feb 19, 2014 Accepting new patients
Xie Jianlin Gastroenterology & Hepatology PLLC Anesthesiology CurrentSince Jan 1, 2015 Accepting new patients

Locations

13602 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-3212

13347 Sanford Ave
Ste 1C
Flushing, NY 11355
Phone (718) 461-9779

3808 Union St
Ste 6A
Flushing, NY 11354
Phone (718) 321-8840

13602 Roosevelt Ave
Bsmt
Flushing, NY 11354
Phone (718) 886-6648

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902826019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "C/O FACULTY PRACTICE MANAGEMENT SUITE I-37 NORTH",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-960-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "C/O FACULTY PRACTICE MANAGEMENT SUITE I-37 NORTH",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-960-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "KEQIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "224136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02285550",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.