Kenneth K Liu, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A39960 Issued in CA

Practice address

305 E Granger Ave
Ste 202
Modesto, CA 95350-4344

Phone

(209) 526-1606

Fax

(209) 526-1677

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Modesto Kidney Medical Group

  • Nephrology Physician
  • Modesto, CA
  • NPI 1306848569
  Medicare reassignment NPD

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1326042391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E GRANGER AVE",
            "address_2": "STE 202",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504344",
            "telephone_number": "209-526-1606",
            "fax_number": "209-526-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E GRANGER AVE",
            "address_2": "STE 202",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504344",
            "telephone_number": "209-526-1606",
            "fax_number": "209-526-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A39960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A399600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Eugene Little
• Mark Ellis Litynsky, PH.D.
• Alexander H Liu, M.D.
• Fan Liu
• Josh Xiao Liu, D.D.S.
• Stephen Kao Liu, M.D.
• Tsang Pin Liu, D.M.D
• Ying Liu, MD
• Liv & Eve Inc.
• Maud E Liva, M.D.

• Nephrology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.

Verify at the official NPI Registry.