Individual provider Active NPI

Kenneth K Liao, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Houston, TX
National Provider Identifier
1417053869
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
S6233 Issued in TX
Practice address
1101 Bates Ave
Houston, TX 77030-2607
Phone
(713) 798-1300
NPI assigned
Sep 15, 2006
Last updated
May 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 42328 MN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 42328 MN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X S6233 TX Primary

Addresses

Primary practice location

1101 Bates Ave
Houston, TX 77030-2607

Mailing address

7200 Cambridge St
Houston, TX 77030-4202

Other practice location 1

6770 Bertner Ave Ste C-355
Houston, TX 77030-2604
Phone (832) 355-3000

Other identifiers 10

IdentifierTypeStateIssuer
18-00070OtherMNMEDICA CHOICE
0554584MedicaidIA
090474100MedicaidMN
18-00014OtherMNMEDICA PRIMARY
1031690OtherMNPREFERRED ONE
224A2LIOtherMNBLUE CROSS BLUE SHIELD
HP40342OtherMNHEALTH PARTNERS
142142OtherMNUCARE
34260200MedicaidWI
506360OtherMNFAIRVIEW

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kliao30349@bcm.ghhdirect.net

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190108002080 TX Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 7618011909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

7200 Cambridge St
Suite 1
Houston, TX 77030-4202
Phone (713) 798-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)43
Pacemaker insertion or repair1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42328MNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
S6233TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 1, 2019 Accepting new patients
Baylor College of Medicine Surgery CurrentSince Jan 1, 2019 Accepting new patients

Locations

1101 Bates Ave
Houston, TX 77030
Phone (713) 798-1300

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

7200 Cambridge St
Houston, TX 77030
Phone (713) 798-2273

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1417053869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BATES AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302607",
            "telephone_number": "713-798-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6770 Bertner Ave Ste C-355",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302604",
            "country_code": "US",
            "telephone_number": "832-355-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIAO",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "42328",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MN",
            "license": "42328",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "S6233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "18-00070",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554584",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090474100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "18-00014",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1031690",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "224A2LI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP40342",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "142142",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34260200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRVIEW",
            "identifier": "506360",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kliao30349@bcm.ghhdirect.net",
            "affiliation": "N",
            "address_1": "1101 Bates Ave",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770302607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.