Individual provider Active NPI

Joanna Liu, O.D., M.S.

  • Optometrist
  • New York, NY
National Provider Identifier
1548965866
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009764 Issued in NY
Practice address
4738 Broadway
New York, NY 10040-1103
Phone
(646) 661-7615
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009764 NY Primary

Addresses

Primary practice location

4738 Broadway
New York, NY 10040-1103

Mailing address

4738 Broadway
New York, NY 10040-1103
Phone (646) 661-7615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240327002684 NY Practitioner - Optometry 0840640728 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Vision Optometry Downtown PLLCGroup PAC ID 2062753114, 4 clinicians

Practice addresses (Care Compare)

60 Saint James PL
New York, NY 10038-1209
Phone (212) 227-1268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
009764NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Vision Family Eyecare Inc Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Compton Optometry PC CurrentSince Mar 9, 2024 Accepting new patients
Metropolitan Vision Optometry Downtown PLLC. Optometrist CurrentSince May 1, 2024 Accepting new patients

Locations

3808 Union St
Ste 3M
Flushing, NY 11354

3808 Union St
Ste 3ML
Flushing, NY 11354
Phone (917) 293-0221

4738 Broadway
New York, NY 10040
Phone (212) 569-5330

60 Saint James Pl
New York, NY 10038
Phone (212) 227-1268

Organizations & group practices 3

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1548965866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4738 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401103",
            "telephone_number": "646-661-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4738 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401103",
            "telephone_number": "646-661-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JOANNA",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.