Individual provider Active NPI

Libo Qiu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Long Island City, NY
National Provider Identifier
1811917370
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
233818 Issued in NY
Practice address
2510 30TH Ave
Long Island City, NY 11102-2448
Phone
(718) 267-4245
NPI assigned
Jul 20, 2006
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 233818 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Long Island City, NY 11102-2448

Mailing address

62 Schoolhouse LN
Roslyn Heights, NY 11577-2820
Phone (917) 592-1268

Other identifiers 1

IdentifierTypeStateIssuer
02756072MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070206000681 NY Practitioner - Pathology 0143222083 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murray Hill Urology PCGroup PAC ID 9335454818, 5 clinicians
Larry Tetsoti MD LLCGroup PAC ID 8325197213, 2 clinicians
Greater New York Gastroenterology LLPGroup PAC ID 1658441860, 5 clinicians

Practice addresses (Care Compare)

120 E 34TH St
New York, NY 10016-4609
Phone (212) 686-1140

23 Brighton 11TH St
Suite 601
Brooklyn, NY 11235-5308
Phone (718) 336-6166

2510 30TH Ave
Long Island City, NY 11102-2448
Phone (718) 267-4221

8545 Eliot Ave
Rego Park, NY 11374-2763
Phone (718) 533-7900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Mount Sinai Hospital CurrentSince Mar 2, 2009 Accepting new patients
Larry Tetsoti MD LLC CurrentSince Jun 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2023 Accepting new patients
Murray Hill Urology, PC CurrentSince May 1, 2023 Accepting new patients
Michael E. Gribetz, MD PC CurrentSince Mar 1, 2019 Accepting new patients
Mount Sinai Hospital CurrentSince Mar 2, 2009 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Eastpath Diagnostics, LLC Current Accepting new patients
Eastgene Laboratories Inc CurrentSince Feb 4, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Sep 5, 2014 Accepting new patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology CurrentSince Sep 5, 2014 Accepting new patients
Uropartners PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1009 Brighton Beach Ave
Ste 5
Brooklyn, NY 11235
Phone (718) 283-6430

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1811917370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 SCHOOLHOUSE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772820",
            "telephone_number": "917-592-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-267-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "LIBO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "233818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02756072",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.