Individual provider Active NPI

Wendy Qiu, M.D.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1053408195
Registry record updated Nov 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
210276 Issued in MA
Practice address
850 Harrison Ave
Boston, MA 02118-4001
Phone
(617) 414-5245
Fax
(617) 638-6836
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 210276 MA Primary

Addresses

Primary practice location

850 Harrison Ave
Boston, MA 02118-4001

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other identifiers 1

IdentifierTypeStateIssuer
110033196AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090120000019 MA Practitioner - Psychiatry 5799848693 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Psychiatry Associates, Inc. Psychiatry CurrentSince Nov 1, 2009 Accepting new patients
Newton-Wellesley Eating Disorders & Behavioral Medicine PastSince Feb 16, 2010 Accepting new patients
Newton-Wellesley Behavioral Medicine & Eating Disorders Past Accepting new patients

Locations

85 East Newton St
Ste 905
Boston, MA 02118
Phone (617) 414-5245

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: wqiu11789@direct.bmc.masshiway.net

Organizations & group practices 4

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415404800000",
    "number": "1053408195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-5245",
            "fax_number": "617-638-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "WENDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2014-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "210276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110033196A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.