Individual provider Active NPI

Miao Qin, FNP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1477918498
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341891 Issued in NY
Practice address
13743 45TH Ave
Flushing, NY 11355-4048
Phone
(929) 362-3006
Fax
(929) 362-3026
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 156135 NC
Family Nurse Practitioner 363LF0000X 341891 NY Primary

Addresses

Primary practice location

13743 45TH Ave
Flushing, NY 11355-4048

Mailing address

125 Walker St FL 2
New York, NY 10013-4135
Phone (212) 226-8866

Other identifiers 1

IdentifierTypeStateIssuer
05448260MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220224000146 NC Practitioner - Nurse Practitioner 1658651914 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
156135NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
DRX High Point, PLLC CurrentSince Aug 9, 2023 Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients

Locations

1653 New Garden Rd
Ste 103
Greensboro, NC 27410
Phone (336) 609-6000

2305 N Main St
High Point, NC 27262
Phone (336) 884-4050

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

1231 Eastchester Dr
High Point, NC 27265
Phone (336) 884-4050

204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066

515 Barbour Rd
Smithfield, NC 27577
Phone (919) 227-6261

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1477918498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13743 45TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554048",
            "telephone_number": "929-362-3006",
            "fax_number": "929-362-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIN",
        "first_name": "MIAO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "156135",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05448260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.