Individual provider Active NPI

Qin Gu

  • Neurology Physician
  • Hudson, FL
National Provider Identifier
1487691507
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME90591 Issued in FL
Practice address
7539 Medical Drive
Hudson, FL 34667
Phone
(727) 869-2115
Fax
(727) 863-6167
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME90591 FL Primary

Addresses

Primary practice location

7539 Medical Drive
Hudson, FL 34667

Mailing address

7539 Medical Drive
Hudson, FL 34667
Phone (727) 869-2115

Other identifiers 1

IdentifierTypeStateIssuer
270471400MedicaidFL

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
I20040812001344 FL Practitioner - Neurology 5597738104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David W Malka MD PAGroup PAC ID 2567435175, 2 clinicians

Practice addresses (Care Compare)

7539 Medical Dr
Hudson, FL 34667-6502
Phone (727) 869-2115

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90591FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David W. Malka MD, PA Neurology CurrentSince Apr 7, 2004 Accepting new patients

Locations

11345 Cortez Blvd
Brooksville, FL 34613
Phone (352) 597-2501

7539 Medical Dr
Hudson, FL 34667
Phone (727) 869-2115

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1487691507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7539 MEDICAL DRIVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-869-2115",
            "fax_number": "727-863-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7539 MEDICAL DRIVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-869-2115",
            "fax_number": "727-863-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GU",
        "first_name": "QIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME90591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270471400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.