Active NPI
Lisa Grossman Liu, MD, PHD
- Pediatrics Physician
- San Francisco, CA
National Provider Identifier
1104566272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A191179
- Practice address
- 1975 4TH St
San Francisco, CA 94143-2351 - Phone
- (415) 476-4562
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A191179 | CA | Primary |
Addresses
Primary practice location
1975 4TH St
San Francisco, CA 94143-2351
Mailing address
15 Escondido Valle
Manitou Springs, CO 80829-2470
Phone (719) 244-0401
Other names 1
- Dr. Lisa Grossman Liu
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230111003173 | CA | Order and Referring Only - Pediatric Medicine | 3274903000 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A191179 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1104566272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 ESCONDIDO VALLE",
"city": "MANITOU SPRINGS",
"state": "CO",
"postal_code": "808292470",
"telephone_number": "719-244-0401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 4TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432351",
"telephone_number": "415-476-4562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "LISA",
"middle_name": "GROSSMAN",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A191179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "GROSSMAN LIU",
"prefix": "DR.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.