Individual provider Active NPI

Baogang Liu, MD

  • Surgery Physician
  • Elizabeth City, NC
National Provider Identifier
1144481029
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2015-02508 Issued in NC
Practice address
1177 N Road St
Elizabeth City, NC 27909-3388
Phone
(252) 384-2560
Fax
(252) 384-9997
NPI assigned
Jun 23, 2008
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Surgery Physician 208600000X 0101269649 VA
Surgery Physician 208600000X 2015-02508 NC Primary
Surgical Oncology Physician 2086X0206X 0101250133 VA

Addresses

Primary practice location

1177 N Road St
Elizabeth City, NC 27909-3388

Mailing address

1177 N Road St
Elizabeth City, NC 27909-3388
Phone (252) 337-9440

Other practice location 1

2232 Wilborn Ave Ste C
South Boston, VA 24592-1662
Phone (434) 517-3910

Other practice location 2

Medical Central Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160930001644 NC Practitioner - General Surgery 7911128731 Reassigns benefits to 1 organization
I20221219000556 VA Practitioner - General Surgery 7911128731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1177 N Rd St
Elizabeth City, NC 27909-3388
Phone (252) 384-2560

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Hernia repair (minimally invasive)1-10
Mastectomy16
Melanoma (skin cancer) excision11
Removal of tissue22
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101250133VAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Health Medical Associates LTD CurrentSince Sep 7, 2022 Accepting new patients
Dominion Health Medical Assoc. Current Accepting new patients
Sentara Medical Group Surgical Oncology CurrentSince Jul 12, 2023 Accepting new patients
Albemarle Physician Services - Sentara, Inc CurrentSince Oct 3, 2016 Accepting new patients
Dominion Health Medical Assoc CurrentSince Sep 7, 2022 Accepting new patients
Albemarle Physician Services - Sentara, Inc Surgery Current Accepting new patients
Albemarle Physician Services - Sentara, Inc Surgery CurrentSince Oct 3, 2016 Accepting new patients

Locations

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

1177 N Road St
Elizabeth City, NC 27909
Phone (252) 337-9440

905 Thunder Rd
Ste 210
Elizabeth City, NC 27909
Phone (252) 334-0460

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2232 Wilborn Ave
Ste C
South Boston, VA 24592
Phone (434) 517-3910

2232 Wilborn Ave
Ste F
South Boston, VA 24592
Phone (434) 517-8095

2790 Godwin Blvd
Ste 305
Suffolk, VA 23434
Phone (757) 934-4222

Interoperability endpoints

  • Direct secure messaging: bliu@direct.health-quest.org
  • Direct secure messaging: bliu264486@direct.sentara.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1144481029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093388",
            "telephone_number": "252-337-9440",
            "fax_number": "252-384-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093388",
            "telephone_number": "252-384-2560",
            "fax_number": "252-384-9997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Wilborn Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245921662",
            "country_code": "US",
            "telephone_number": "434-517-3910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Medical Central Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "BAOGANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101269649",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2015-02508",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "VA",
            "license": "0101250133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.