Individual provider Active NPI

Shuqiang Qi

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1700230729
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040048 Issued in NY
Practice address
10714 71St Rd FL 1
Forest Hills, NY 11375-4719
Phone
(718) 755-2999
Fax
(347) 710-8806
NPI assigned
Apr 15, 2016
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040048 NY Primary

Addresses

Primary practice location

10714 71St Rd FL 1
Forest Hills, NY 11375-4719

Mailing address

7211 Austin Street, MB#194
Forest Hills, NY 11375-5354
Phone (917) 563-8610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420001508 NY Practitioner - Physical Therapist in Private Practice 6800159039 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040048NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Everbright Physical Therapy PLLC Physical Therapist CurrentSince Dec 6, 2017 Accepting new patients

Locations

13508 Roosevelt Ave
Ste 203
Flushing, NY 11354

13511 40th Rd
Ste 3A
Flushing, NY 11354
Phone (646) 417-0641

7211 Austin St
Forest Hills, NY 11375
Phone (646) 397-1769

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.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1700230729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 AUSTIN STREET, MB#194",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "917-563-8610",
            "fax_number": "347-710-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10714 71ST RD FL 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754719",
            "telephone_number": "718-755-2999",
            "fax_number": "347-710-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QI",
        "first_name": "SHUQIANG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.