Individual provider Active NPI

Jack Qiu, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1720601735
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA12823800 Issued in NJ
Practice address
111 S 11TH St
Philadelphia, PA 19107-4870
Phone
(215) 955-6161
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD490765 PA
Anesthesiology Physician 207L00000X 25MA12823800 NJ Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4870

Mailing address

111 S 11TH St Ste 8280
Philadelphia, PA 19107-4870
Phone (215) 955-6161

Other practice location 1

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250916000438 NJ Practitioner - Anesthesiology 6406350347 Reassigns benefits to 1 organization
I20250916000776 PA Practitioner - Anesthesiology 6406350347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Methodist Associates in Healthcare of New Jersey, P.C.Group PAC ID 4981965324, 136 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 346-6000

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 488-6500

3140 Princeton Pike
FL 2
Lawrenceville, NJ 08648-2330
Phone (609) 895-1919

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (833) 958-2198

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 1, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Jefferson University Physicians Anesthesiology CurrentSince Sep 1, 2025 Accepting new patients
Methodist Associates in Healthcare of New Jersey, P.C. CurrentSince Nov 1, 2025 Accepting new patients
Methodist Associates in Healthcare of New Jersey, P.C. Anesthesiology Current Accepting new patients
Jefferson University Physicians PastSince Aug 25, 2025 Accepting new patients

Locations

3140 Princeton Pike
Fl 2
Lawrenceville, NJ 08648
Phone (609) 895-1919

1 Union St
Ste 101
Trenton, NJ 08691
Phone (609) 632-0140

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

111 S 11th St
Ste 8280
Philadelphia, PA 19107
Phone (215) 955-2370

Organizations & group practices 6

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1720601735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8280",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074870",
            "telephone_number": "215-955-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074870",
            "telephone_number": "215-955-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Hurffville Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122453",
            "country_code": "US",
            "telephone_number": "856-582-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QIU",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD490765",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA12823800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.