Individual provider Active NPI

Young Liu, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1467114769
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT030965 Issued in PA
Practice address
3400 Lancaster Ave
Philadelphia, PA 19104-4964
Phone
(215) 662-0397
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-025511 IL
Physical Therapist 225100000X PT030965 PA Primary

Addresses

Primary practice location

3400 Lancaster Ave
Philadelphia, PA 19104-4964

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

1031 S Roselle Rd
Schaumburg, IL 60193-3960
Phone (847) 895-1866

Other practice location 2

4005 Ludlow St
Philadelphia, PA 19104-5826
Phone (267) 529-0050

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506004333 CA Practitioner - Physical Therapist in Private Practice 6002204245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-025511ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Feb 20, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Feb 20, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2024 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

4005 Ludlow St
Philadelphia, PA 19104
Phone (267) 529-0050

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1467114769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LANCASTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044964",
            "telephone_number": "215-662-0397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 S Roselle Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601933960",
            "country_code": "US",
            "telephone_number": "847-895-1866",
            "fax_number": "847-895-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4005 Ludlow St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191045826",
            "country_code": "US",
            "telephone_number": "267-529-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "YOUNG",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2024-12-30",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-025511",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.