Shannen Liu

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

58A W 15TH St
New York, NY 10011-6835

Phone

(212) 242-5815

NPI assigned

Jan 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

JS Weill Medical College, Cornell University, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ar Dermatology PCGroup PAC ID 9436682713, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ar Dermatology PC

  • Dermatology Physician
  • New York, NY
  • NPI 1710710900
  Medicare reassignment Care Compare group
• Ji Medical PC

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1366035248
  Medicare reassignment
• Vanguard Dermatology

  • Specialist
  • Brooklyn, NY
  • NPI 1619179009
  Medicare reassignment
• Sadick Aesthetic Surgery and Dermatology

  • Dermatology Physician
  • New York, NY
  • NPI 1699920116
  NPD (past)

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663459200000",
    "number": "1194181982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58A W 15TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116835",
            "telephone_number": "212-242-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58A W 15TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116835",
            "telephone_number": "212-242-5815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Park Ave Apt 1A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100750385",
            "country_code": "US",
            "telephone_number": "212-772-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "SHANNEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2022-09-18",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruosi Liu, MD
• Sally Liu
• Sean Liu, MD
• Sean Ting Liu
• Serena Liu, VMD
• Shawn Shukuang Liu, M.D.
• Sherry Shu Liu, OD
• Shihua Liu
• Shirley Liu, PA-C
• Shou-an Liu, PT, DPT, OCS

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2022; 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.