Individual provider Active NPI

Frederic Luo, MD

  • Internal Medicine Physician
  • Queen Creek, AZ
National Provider Identifier
1275690992
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31254 Issued in AZ
Practice address
22707 S Ellsworth Rd Ste 105
Queen Creek, AZ 85142-6132
Phone
(480) 888-1900
Fax
(480) 888-1934
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31254 AZ Primary

Addresses

Primary practice location

22707 S Ellsworth Rd Ste 105
Queen Creek, AZ 85142-6132

Mailing address

PO Box 1108
Lake Havasu City, AZ 86405-1108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070911000103 AZ Practitioner - Internal Medicine 6103801519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

22707 S Ellsworth Rd
H105
Queen Creek, AZ 85142-6132
Phone (480) 888-1900

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31254AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Internal Medicine PC Internal Medicine CurrentSince Aug 1, 2007 Accepting new patients
Frederic Luo, MD, Msee, Inc Internal Medicine PastSince Jan 29, 2001 Accepting new patients

Locations

22707 S Ellsworth Rd
Ste H105
Queen Creek, AZ 85142
Phone (480) 289-4550

22707 S Ellsworth Rd
Queen Creek, AZ 85142
Phone (480) 677-3494

22707 S Ellsworth Rd
Ste 105
Queen Creek, AZ 85142
Phone (480) 677-2800

Interoperability endpoints

  • Direct secure messaging: gehfluo@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/AAAADD

Organizations & group practices 2

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 1

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1275690992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22707 S ELLSWORTH RD STE 105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426132",
            "telephone_number": "480-888-1900",
            "fax_number": "480-888-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "FREDERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.