Individual provider Active NPI

Gaston Mike Liu, DPM

  • Foot & Ankle Surgery Podiatrist
  • Commack, NY
National Provider Identifier
1104271469
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N007083-01 Issued in NY
Practice address
366 Veterans Memorial Hwy Ste 9
Commack, NY 11725-4351
Phone
(631) 836-6651
Fax
(631) 883-6636
NPI assigned
Apr 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N007083 NY
Foot & Ankle Surgery Podiatrist 213ES0103X N007083-01 NY Primary

Addresses

Primary practice location

366 Veterans Memorial Hwy Ste 9
Commack, NY 11725-4351

Mailing address

57 Southern Blvd Ste 1
Nesconset, NY 11767-1091
Phone (631) 634-5448

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615000319 NY Practitioner - Podiatry 8022430305 Reassigns benefits to 3 organizations
Practice locations: Commack, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

366 Veterans Memorial Hwy
Suite 9
Commack, NY 11725-4351
Phone (631) 836-6651

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue175
Removal of skin lesions24
Removal of nail tissue545
Removal or shaving of skin growth256

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N007083NYMDFoot & Ankle Surgery Podiatrist
N007083-01NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Mike Liu LLC Foot & Ankle Surgery CurrentSince Feb 3, 2025 Accepting new patients
Phase Two Podiatry PC CurrentSince Jun 13, 2023 Accepting new patients
Medical Director Services PC CurrentSince May 29, 2023 Accepting new patients
Family Allergy and Asthma Care, PLLC PastSince Feb 3, 2025 Accepting new patients

Locations

620 Sleepy Hollow Rd
Briarcliff Manor, NY 10510
Phone (800) 501-3936

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

366 Veterans Memorial Hwy
Ste 9
Commack, NY 11725
Phone (631) 836-6651

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

301 Mill Rd
Ste U7
Hewlett, NY 11557

57 Southern Blvd
Ste 1
Nesconset, NY 11767
Phone (631) 584-0069

193 S Union Rd
Williamsville, NY 14221
Phone (716) 276-1900

Organizations & group practices 4

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": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1104271469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SOUTHERN BLVD STE 1",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671091",
            "telephone_number": "631-634-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 VETERANS MEMORIAL HWY STE 9",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254351",
            "telephone_number": "631-836-6651",
            "fax_number": "631-883-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "GASTON",
        "middle_name": "MIKE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N007083",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N007083-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.