Individual provider Active NPI

Ryan Queen, M.D.

  • Emergency Medicine Physician
  • Orlando, FL
National Provider Identifier
1487060026
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME130879 Issued in FL
Practice address
1414 Kuhl Ave # MP31
Orlando, FL 32806
Phone
(407) 237-6329
Fax
(407) 649-3083
NPI assigned
Jul 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME130879 FL Primary

Addresses

Primary practice location

1414 Kuhl Ave # MP31
Orlando, FL 32806

Mailing address

1414 Kuhl Ave # MP31
Orlando, FL 32806-2008
Phone (407) 237-6329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170519001023 FL Practitioner - Emergency Medicine 9133348980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Emergency Medicine of Broward LLCGroup PAC ID 5991793002, 69 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 939-5000

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039
  • Broward Health Coral Springs Hospital, Coral Springs, FL, CCN 100276

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Feb 3, 2018 Accepting new patients
Emergency Physicians of Central Florida LLP Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine Current Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Feb 3, 2018 Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

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.

Hospital & facility affiliations 2

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1487060026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 KUHL AVE # MP31",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "407-237-6329",
            "fax_number": "407-649-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 KUHL AVE # MP31",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "407-237-6329",
            "fax_number": "407-649-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME130879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.