Liza Antoinette Jain Phu, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

53359 Issued in MN

Practice address

265 Creek LN S
Jordan, MN 55352-1214

Phone

(952) 428-1200

Fax

(952) 428-1201

NPI assigned

May 22, 2009

Last updated

Nov 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Liza Antoinette Garcia Jain Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Family Practice

Education

University of Minnesota Medical School, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Francis Regional Medical CenterGroup PAC ID 7214821909, 120 clinicians

Allina Health SystemGroup PAC ID 4587573613, shared by 87 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Allina Health Home Health Home health agency, Minneapolis, MN, CCN 248091
• St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lphu267037@excellian.direct.allina.com

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.

• St. Francis Regional Medical Center

  dba St. Francis Urgent Care - Southbridge

  • Urgent Care Clinic/Center
  • Shakopee, MN
  • NPI 1447605514
  Medicare reassignment Care Compare group NPD
• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Bandana Square Clinic

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1023314804
  NPD
• Allina Health System

  dba Courage Kenny Rehabilitation Associates

  • Physical Medicine & Rehabilitation Physician
  • Coon Rapids, MN
  • NPI 1770034670
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• St Francis Regional Medical Center

  dba St Francis - Jordan Clinic

  • Clinic/Center
  • Jordan, MN
  • NPI 1972857597
  NPD
• Courage Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Golden Valley, MN
  • NPI 1992795280
  NPD (past)
• St Francis Regional Medical Center

  • General Acute Care Hospital
  • Shakopee, MN
  • NPI 1578520045
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Allina Health System

  dba Allina Health Home Health

  • Home Health Agency
  • Minneapolis, MN
  • NPI 1316985039
  Care Compare affiliation
• St Francis Regional Medical Center

  • General Acute Care Hospital
  • Shakopee, MN
  • NPI 1578520045
  Care Compare affiliation

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1174758908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 CREEK LN S",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521214",
            "telephone_number": "952-428-1200",
            "fax_number": "952-428-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHU",
        "first_name": "LIZA ANTOINETTE",
        "middle_name": "JAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60116222",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.129032",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lphu267037@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "265 Creek Ln S",
            "city": "Jordan",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553521214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LIZA ANTOINETTE",
            "last_name": "JAIN",
            "middle_name": "GARCIA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Oak Terrace Senior Housing of Jordan
• April Orr
• Penney Family Chiropractic, LLC
• Hollie Penney, D.C.
• Scott Charles Penney, D.C.
• Amanda Preiner, OTR/L
• Kiirsten Rakers, BS
• Alicia Ray, PT
• Ruby Sky Therapy and Wellness
• Karis Rygg, LAC

• Family Medicine Physician in Jordan, MN
• Providers in Jordan, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.