Active NPI
Jia Qin
- Anatomic Pathology & Clinical Pathology Physician
- Brooklyn, NY
National Provider Identifier
1962763490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 288734
- Practice address
- 800 Poly PL
Brooklyn, NY 11209 - Phone
- (718) 836-6600
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 288734 | NY | Primary |
Addresses
Primary practice location
800 Poly PL
Brooklyn, NY 11209
Mailing address
800 Poly PL
Brooklyn, NY 11209-7104
Phone (718) 836-6600
Other practice location 1
450 Clarkson Ave
Box #25
Brooklyn, NY 11203-2012
Phone (312) 730-2081
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160922001830 | MA | Order and Referring Only - Pathology | 0941597793 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1962763490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "718-836-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11209",
"telephone_number": "718-836-6600"
}
],
"practiceLocations": [
{
"address_1": "450 Clarkson Ave",
"address_2": "Box #25",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112032012",
"country_code": "US",
"telephone_number": "312-730-2081",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QIN",
"first_name": "JIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-31",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "288734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.