Individual provider Active NPI

Jessie Li-Wei Liu, O.D.

  • Optometrist
  • Marysville, WA
National Provider Identifier
1447267885
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60304885 Issued in WA
Practice address
1098 Alder Ave
Marysville, WA 98270-4318
Phone
(360) 659-6255
Fax
(360) 653-2466
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13119 CA
Optometrist 152W00000X OD60304885 WA Primary

Addresses

Primary practice location

1098 Alder Ave
Marysville, WA 98270-4318

Mailing address

PO Box 965
Everett, WA 98206-0965
Phone (510) 473-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121116000560 WA Practitioner - Optometry 8729150990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Practice addresses (Care Compare)

1098 Alder Ave
Marysville, WA 98270-4318
Phone (360) 659-6255

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Washington Professional PC Optometrist CurrentSince Jan 24, 2023 Accepting new patients
William Y. to, O.D., Inc Optometrist PastSince Aug 25, 2019 Accepting new patients
East Bay Eye Centers Medical Corporation Past Accepting new patients
Berkeley California Optometric, Inc Optometrist PastSince Oct 13, 2016 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

12310 NE 8th St
Ste 101
Bellevue, WA 98005
Phone (425) 455-0001

1098 Alder Ave
Marysville, WA 98270
Phone (360) 659-6255

Organizations & group practices 5

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1447267885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 965",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982060965",
            "telephone_number": "510-473-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 ALDER AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704318",
            "telephone_number": "360-659-6255",
            "fax_number": "360-653-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JESSIE",
        "middle_name": "LI-WEI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13119",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60304885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.