Individual provider Active NPI

Melanie Liu

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1568217370
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64264 Issued in CA
Practice address
2065 Los Gatos Almaden Rd
San Jose, CA 95124-5417
Phone
(408) 377-9275
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64264 CA Primary

Addresses

Primary practice location

2065 Los Gatos Almaden Rd
San Jose, CA 95124-5417

Mailing address

4014 Kelvington CT
San Jose, CA 95121-2616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509001190 CA Practitioner - Physician Assistant 3577904465 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4014 Kelvington CT
San Jose, CA 95121-2616

436 S Magnolia Ave
El Cajon, CA 92020-5219

5 Hutton Centre Dr
Suite 950
Santa Ana, CA 92707-8786

Hospital & facility affiliations

  • VN Home Health Care Home health agency, San Jose, CA, CCN 058278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64264CAMDPharmacist
PA64264CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Talami Health & Wellness, Inc. Past Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1568217370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 KELVINGTON CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951212616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 LOS GATOS ALMADEN RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951245417",
            "telephone_number": "408-377-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "MELANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.