Individual provider Active NPI

Guoqiong Qu, MD

  • Urgent Care Clinic/Center
  • New York, NY
National Provider Identifier
1154841088
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Practice address
100 E Broadway Unit 1C
New York, NY 10002-7188
Phone
(646) 398-8054
Fax
(929) 352-4214
NPI assigned
Jun 21, 2017
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary
General Practice Physician 208D00000X 295268 NY

Addresses

Primary practice location

100 E Broadway Unit 1C
New York, NY 10002-7188

Mailing address

3147 137TH St Ste CF
Flushing, NY 11354-2667
Phone (917) 563-1111

Other practice location 1

3147 137th St Ste Cf
Flushing, NY 11354-2667
Phone (332) 600-3996

Other names 1

  • Guoqiong Katherine Qu Professional name

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
I20180208000449 NY Practitioner - General PracticePractitioner - Family Practice 5597025775 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295268NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Hills Dermatology Group PLLC CurrentSince Dec 18, 2017 Accepting new patients
Cliffside Nursing Home Inc Past Accepting new patients

Networks

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

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, 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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1154841088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 137TH ST STE CF",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542667",
            "telephone_number": "917-563-1111",
            "fax_number": "929-352-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E BROADWAY UNIT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027188",
            "telephone_number": "646-398-8054",
            "fax_number": "929-352-4214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3147 137th St Ste Cf",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113542667",
            "country_code": "US",
            "telephone_number": "332-600-3996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QU",
        "first_name": "GUOQIONG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2024-06-07",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "295268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUOQIONG",
            "last_name": "QU",
            "middle_name": "KATHERINE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.