Individual provider Active NPI

Mimi Liu, MD

  • Retina Specialist (Ophthalmology) Physician
  • Englewood, CO
National Provider Identifier
1568469625
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
0043378 Issued in CO
Practice address
850 Englewood Pkwy Ste 200
Englewood, CO 80110-7399
Phone
(303) 261-1600
Fax
(303) 261-1601
NPI assigned
Jul 5, 2005
Last updated
Mar 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 43378 CO
Retina Specialist (Ophthalmology) Physician 207WX0107X 0043378 CO Primary

Addresses

Primary practice location

850 Englewood Pkwy Ste 200
Englewood, CO 80110-7399

Mailing address

8101 E Lowry Blvd Ste 210
Denver, CO 80230-7195
Phone (303) 261-1600

Other identifiers 1

IdentifierTypeStateIssuer
36633038MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20050511000313 CO Practitioner - Ophthalmology 3173563004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Baylor College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Retina Associates, PLLCGroup PAC ID 6002817566, 15 clinicians

Practice addresses (Care Compare)

255 S Routt St
Suite 200
Lakewood, CO 80228-2271
Phone 30326116001862

Merit-based Incentive Payment System (MIPS)

Final score
98.8 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0043378COMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Retina Associates, PLLC Retina Specialist Current Accepting new patients
Colorado Retina Associates, PLLC Retina Specialist CurrentSince Jan 1, 2007 Accepting new patients
Colorado Retina Associates, PLLC Ophthalmology CurrentSince Jan 1, 2007 Accepting new patients
Retinal Alliance, PC Past Accepting new patients

Locations

850 E Harvard Ave
Ste 155
Denver, CO 80210
Phone (303) 778-1910

8101 E Lowry Blvd
Ste 210
Denver, CO 80230
Phone (720) 321-3550

55 Madison St
Ste 300
Denver, CO 80206
Phone (303) 393-8565

3401 Quebec St
Ste 105
Denver, CO 80207

850 Englewood Pkwy
Ste 200
Englewood, CO 80110

360 Peak One Dr
Ste 300
Frisco, CO 80443
Phone (720) 321-8460

1050 W South Boulder Rd
Ste 2100
Lafayette, CO 80026

255 S Routt St
Ste 200
Lakewood, CO 80228
Phone 30326116001862

11960 Lioness Way
Ste 290
Parker, CO 80134
Phone 30326116001862

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1568469625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-261-1600",
            "fax_number": "303-261-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 ENGLEWOOD PKWY STE 200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801107399",
            "telephone_number": "303-261-1600",
            "fax_number": "303-261-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "MIMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "43378",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CO",
            "license": "0043378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36633038",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.