Individual provider Active NPI

Joseph Liu, D.C., QME

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1396837993
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 25592 Issued in CA
Practice address
2323 Bethards Dr
Santa Rosa, CA 95405-8500
Phone
(707) 576-7000
Fax
(707) 576-0656
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 25592 CA Primary

Addresses

Primary practice location

2323 Bethards Dr
Santa Rosa, CA 95405-8500

Mailing address

2323 Bethards Dr
Santa Rosa, CA 95405-8500
Phone (707) 576-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000479 CA Practitioner - Chiropractic 5294863031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group a Professional CorporationGroup PAC ID 9830164961, 2 clinicians

Practice addresses (Care Compare)

4655 Hoen Ave
Suite 4
Santa Rosa, CA 95405-7830
Phone (707) 576-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 25592CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group a Professional Corporation Chiropractor CurrentSince Jul 3, 1998 Accepting new patients
Providence Medical Foundation PastSince Jul 3, 1998 Accepting new patients

Locations

4655 Hoen Ave
Ste 4
Santa Rosa, CA 95405
Phone (707) 546-2057

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396837993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 BETHARDS DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058500",
            "telephone_number": "707-576-7000",
            "fax_number": "707-576-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 BETHARDS DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058500",
            "telephone_number": "707-576-7000",
            "fax_number": "707-576-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JOSEPH",
        "credential": "D.C., QME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 25592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.