Individual provider Active NPI

Shang Liu, MD

  • Child & Adolescent Psychiatry Physician
  • Flushing, NY
National Provider Identifier
1013921246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
228075 Issued in NY
Practice address
4128 Haight Street Unit 1C
Flushing, NY 11355-4271
Phone
(718) 321-8112
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 228075 NY Primary

Addresses

Primary practice location

4128 Haight Street Unit 1C
Flushing, NY 11355-4271

Mailing address

4128 Haight Street Unit 1C
Flushing, NY 11355-4271
Phone (718) 321-8112

Other identifiers 1

IdentifierTypeStateIssuer
02436359MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Psychiatric Centers, Inc Past Accepting new patients
Steinway Child and Family Services, Inc. Past Accepting new patients
Brooklyn Psychiatric Centers, Inc Past Accepting new patients
Steinway Child and Family Services, Inc Past Accepting new patients
Brooklyn Psychiatric Centers Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013921246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 HAIGHT STREET UNIT 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554271",
            "telephone_number": "718-321-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 HAIGHT STREET UNIT 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554271",
            "telephone_number": "718-321-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "SHANG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "228075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02436359",
            "state": "NY"
        }
    ],
    "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 Jul 8, 2007; 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.