NPIMap

Individual provider Active NPI

Jimmy Liu, P.A.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1114186970
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003671 Issued in MD
Practice address
301 Saint Paul PL
5TH Floor
Baltimore, MD 21202-2102
Phone
(410) 332-9404
Fax
(410) 347-5599
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003671 MD Primary
Surgical Physician Assistant 363AS0400X C0003671 MD

Addresses

Primary practice location

301 Saint Paul PL
5TH Floor
Baltimore, MD 21202-2102

Mailing address

301 Saint Paul PL
5TH Floor
Baltimore, MD 21202-2102
Phone (410) 332-9404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080728000359 MD Practitioner - Physician Assistant 7416021209 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Vascular Specialty Services, LLCGroup PAC ID 2466443197, 7 clinicians
Johns Hopkins UniversityGroup PAC ID 4981745098, 711 clinicians
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

301 Saint Paul Place
Medical Staff Office
Baltimore, MD 21202-2102

301 Saint Paul St
FL 5
Baltimore, MD 21202-2102
Phone (410) 332-9404

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 332-9404

Hospital & facility affiliations

  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008
  • Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Merit-based Incentive Payment System (MIPS)

Final score
92.01 of 100Reported as group
Quality
93.41
Promoting interoperability
100
Improvement activities
40
Cost
79.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003671MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Apr 1, 2021 Accepting new patients
Johns Hopkins University CurrentSince Nov 4, 2017 Accepting new patients
Johns Hopkins University CurrentSince Nov 4, 2017 Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2021 Accepting new patients
Joseph S. Fastow, M.D., P.a. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

4940 Eastern Ave
Baltimore, MD 21224

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

Interoperability endpoints

  • Direct secure messaging: jliu8727@direct.mdmercy.com

Organizations & group practices 7

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 3

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1114186970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "address_2": "5TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9404",
            "fax_number": "410-347-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "address_2": "5TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9404",
            "fax_number": "410-347-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JIMMY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003671",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0003671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.