Individual provider Active NPI

Grace Liu

  • Cardiovascular Disease Physician
  • Antioch, CA
National Provider Identifier
1013379882
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A161216 Issued in CA
Practice address
4053 Lone Tree Way
Antioch, CA 94531-6210
Phone
(925) 776-7725
Fax
(510) 506-7728
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X A161216 CA Primary

Addresses

Primary practice location

4053 Lone Tree Way
Antioch, CA 94531-6210

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (925) 776-7725

Other practice location 1

350 John Muir Pkwy
Brentwood, CA 94513-5183
Phone (925) 776-7725

Other identifiers 1

IdentifierTypeStateIssuer
A161216OtherCASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221026002962 CA Practitioner - Cardiovascular Disease (Cardiology) 1850625724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Kentucky College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

350 30TH St
Suite 100
Oakland, CA 94609-3422
Phone (510) 204-8290

350 Hawthorne Ave
Oakland, CA 94609-3108
Phone (510) 655-4000

350 John Muir Pkwy
Brentwood, CA 94513-5183

365 Hawthorne Ave
Oakland, CA 94609-3115

3901 Lone Tree Way
Antioch, CA 94509-6200
Phone (650) 845-7649

Hospital & facility affiliations

  • Sutter Delta Medical Center Hospital, Antioch, CA, CCN 050523
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A161216CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
Sutter East Bay Medical Foundation Cardiovascular Disease Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

4053 Lone Tree Way
Ste 200
Antioch, CA 94531
Phone (925) 756-3400

4053 Lone Tree Way
Antioch, CA 94531
Phone (925) 756-3400

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

350 John Muir Pkwy
Ste 175
Brentwood, CA 94513
Phone (925) 513-2483

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

Interoperability endpoints

  • Direct secure messaging: gliu630167@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1013379882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "925-776-7725",
            "fax_number": "510-506-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316210",
            "telephone_number": "925-776-7725",
            "fax_number": "510-506-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 John Muir Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945135183",
            "country_code": "US",
            "telephone_number": "925-776-7725",
            "fax_number": "510-506-7727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A161216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A161216",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.