NPIMap

Organization Active NPI

Dr Jingbo Liu Physician PC

Doing business as Doctors Immedicare

  • Internal Medicine Physician
  • West Hempstead, NY
National Provider Identifier
1053685727
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR JINGBO LIU PHYSICIAN PC
Doing business as
Doctors Immedicare
Practice address
199 Hempstead Tpke
West Hempstead, NY 11552-1536
Phone
(516) 565-4110
Fax
(516) 565-3313
NPI assigned
Feb 28, 2012
Last updated
Feb 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Mr. Jingbo Liu, M.D.NPI 1003938770
Title
Director
Phone
(516) 565-4110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NY Primary

Addresses

Primary practice location

199 Hempstead Tpke
West Hempstead, NY 11552-1536

Mailing address

199 Hempstead Tpke
West Hempstead, NY 11552-1536
Phone (516) 565-4110

Other names 1

  • DOCTORS IMMEDICARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120406000166 NY Part B Supplier - Clinic/Group Practice 7810158599 Receives reassigned benefits from 2 practitioners
Practice locations: West Hempstead, NY

National Provider Directory

National Provider Directory

Locations

199 Hempstead Tpke
West Hempstead, NY 11552
Phone (516) 565-4110

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1053685727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 HEMPSTEAD TPKE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521536",
            "telephone_number": "516-565-4110",
            "fax_number": "516-565-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 HEMPSTEAD TPKE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521536",
            "telephone_number": "516-565-4110",
            "fax_number": "516-565-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JINGBO LIU PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "JINGBO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-565-4110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOCTORS IMMEDICARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Hempstead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.