NPIMap

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
Last updated
Aug 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 2

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

Addresses

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150603001206 MI Practitioner - Urology 9830410885 Reassigns benefits to 1 organization

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 PCGroup PAC ID 1052223492, 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

National Provider Directory

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

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
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
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
Michigan Institute of Urology, PC Past Accepting new patients
Michigan Institute of Urology PC 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

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.