Juan Liu

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0006000 Issued in MD

Practice address

3820 Bonnybridge PL
Ellicott City, MD 21043-4133

Phone

(443) 854-4748

NPI assigned

Dec 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology Group LLCGroup PAC ID 2466728282, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Integrated Dermatology Group, LLC

  • Dermatology Physician
  • Columbia, MD
  • NPI 1902327950
  Medicare reassignment Care Compare group
• Integrated Dermatology Group, LLC

  • Dermatology Physician
  • Brighton, MA
  • NPI 1265941082
  NPD

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1396100095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 BONNYBRIDGE PL",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434133",
            "telephone_number": "443-854-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 BONNYBRIDGE PL",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434133",
            "telephone_number": "443-854-4748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8890 McGaw Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210454743",
            "country_code": "US",
            "telephone_number": "410-203-0607",
            "fax_number": "410-203-0677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0006000",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0006000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Lisk
• Patricia Ann Liszewski, M.D.
• Danielle Little, PTA
• Nyjla Littlejohn, LMT
• Helen H Liu
• Susan J Liu, MD
• Oyenike Modupe Liwunje
• Evelyn White Lloyd, RN,MS,CS-P
• Carol Joy Loeb, RN
• Cynthia A Loeper, MSW

• Medical Physician Assistant in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.