Active NPI
Che Liu, MD
- Internal Medicine Physician
- Flushing, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 309005
- Practice address
- 13668 Roosevelt Ave Ste 2B
Flushing, NY 11354-5510 - Phone
- (718) 435-1025
- NPI assigned
- Mar 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 25MA11105000 | NJ | |
| Internal Medicine Physician | 207R00000X | 309005 | NY | Primary |
Addresses
Primary practice location
13668 Roosevelt Ave Ste 2B
Flushing, NY 11354-5510
Mailing address
79 Flagg CT
Staten Island, NY 10304-1157
Phone (646) 409-2508
Other practice location 1
595 Division St
Elizabeth, NJ 07201-2038
Phone (908) 289-5646
Other practice location 2
824 55th St
Brooklyn, NY 11220-3263
Phone (718) 435-1025
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA11105000 | NJ | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
| 309005 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clear Lake Medical PC | Current | Accepting new patients | |
| Polaris Care Medical PC | Internal Medicine | Current | Accepting new patients |
Locations
13668 Roosevelt Ave
Ste 2B
Flushing, NY 11354
Phone (646) 409-2508
93 New Dorp Ln
#1
Staten Island, NY 10306
Phone (646) 409-2508
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1003554999
-
- Acupuncturist
- Staten Island, NY
- NPI 1609605526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701475200000",
"number": "1013379791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 FLAGG CT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103041157",
"telephone_number": "646-409-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13668 ROOSEVELT AVE STE 2B",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545510",
"telephone_number": "718-435-1025"
}
],
"practiceLocations": [
{
"address_1": "595 Division St",
"address_purpose": "LOCATION",
"city": "Elizabeth",
"state": "NJ",
"postal_code": "072012038",
"country_code": "US",
"telephone_number": "908-289-5646",
"fax_number": "908-351-1099",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "824 55th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112203263",
"country_code": "US",
"telephone_number": "718-435-1025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "CHE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-22",
"last_updated": "2023-12-02",
"certification_date": "2023-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "NJ",
"license": "25MA11105000",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "309005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.