Individual provider Active NPI

Azra Qureshi, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1962479998
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD060880L Issued in PA
Practice address
1602-04 Wadsworth Avenue
Philadelphia, PA 19150
Phone
(215) 753-9438
Fax
(215) 753-9447
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD060880L PA Primary

Addresses

Primary practice location

1602-04 Wadsworth Avenue
Philadelphia, PA 19150

Mailing address

101 E Olney Ave
400
Philadelphia, PA 19120-2421
Phone (215) 254-2630

Other identifiers 1

IdentifierTypeStateIssuer
0016169100005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD060880LPAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: azra.qureshi@direct.einstein.edu

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1962479998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-254-2630",
            "fax_number": "215-753-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602-04 WADSWORTH AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19150",
            "telephone_number": "215-753-9438",
            "fax_number": "215-753-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "AZRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD060880L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016169100005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.