Individual provider Active NPI

Zachary Jonathan Liss, M.D.

  • Pediatric Urology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1457592990
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
4301092867 Issued in MI
Practice address
20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone
(586) 771-4820
NPI assigned
Mar 12, 2009
Sex
Male
Sole proprietor
No

Organizations & group practices 25

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.

View all 25

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Institute of Urology PC 82 clinicians

Practice addresses (Care Compare)

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.01
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150603001206 MI Practitioner - Urology 9830410885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301092867MIMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Jul 1, 2015 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Jul 1, 2015 Accepting new patients
Michigan Institute of Urology PC Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Beaumont Medical Group- Specialty Services Past Accepting new patients
Michigan Institute of Urology PC Urology Past Accepting new patients
Michigan Institute of Urology PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology Past Accepting new patients

Locations

25500 Meadowbrook Rd
Ste 225
Novi, MI 48375
Phone (248) 426-1300

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

11051 Hall Rd
Ste 200
Utica, MI 48317
Phone (586) 254-5759

Interoperability endpoints

  • Direct secure messaging: zliss@direct.dmc.org
  • Direct secure messaging: zliss1139345@direct.hfhs.org
  • Direct secure messaging: zliss1243902@epic00.shdirect.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Urology Physician 2088P0231X 4301092867 MI Primary
Urology Physician 208800000X 4301092867 MI

Addresses

NPPES NPI Registry

Primary practice location

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200

Mailing address

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
CB9133OtherMIRAILROAD MEDICARE
340E062730OtherMIBCBSM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2015.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1457592990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "ZACHARY",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-12",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "MI",
            "license": "4301092867",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301092867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB9133",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "340E062730",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.