Individual provider Active NPI

Edwin Qiu

  • Student in an Organized Health Care Education/Training Program
  • Newton, MA
National Provider Identifier
1619763711
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2014 Washington St
Newton, MA 02462-1607
Phone
(917) 930-6386
Fax
(917) 930-6386
NPI assigned
Apr 16, 2025
Last updated
Jan 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2014 Washington St
Newton, MA 02462-1607

Mailing address

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250630003942 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8022521327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1619763711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-243-6000",
            "fax_number": "617-243-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "917-930-6386",
            "fax_number": "917-930-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "EDWIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-16",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.