CQC HEALTHCARE PA – Internal Medicine Physician, NPI 1215476239
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CQC HEALTHCARE PA
Hallandale Beach, Broward County, Florida, United States
HALLANDALE BEACH, FL 330080091
Phone: (814) 449-3605
Type: Mailing
3816 Hollywood Blvd Ste 205
Hollywood, FL 330216750
Phone: (786) 207-4788
Fax: (954) 568-8630
Type: Location
1600 S FEDERAL HWY STE 550
POMPANO BEACH, FL 330627518
Phone: (786) 207-4788
Fax: (954) 568-8630
Type: Location
East Sample Road, Pompano Beach, Broward County, Florida, 33064, United States
POMPANO BEACH, FL 33064
Phone: (786) 207-4788
Fax: (954) 416-6677
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-09-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (740 days ago).
Enrollment records
1
Earliest due date
2024-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170922000973 | O | Clinic/Group Practice | FL | 2024-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33008)
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