Jennifer Liu, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

2200 Northern Blvd Ste 115
Greenvale, NY 11548-1220

Phone

(516) 325-7310

NPI assigned

Apr 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (2 of 6)

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• Metro Dermatology of Ny,PC

  • Physician Assistant
  • Flushing, NY
  • NPI 1336343268

  NY

  Medicare reassignment NPD
• Metro Dermatology of NJ,PA

  • Procedural Dermatology Physician
  • Fort Lee, NJ
  • NPI 1437353372
  NPD (past)

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1609301167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NORTHERN BLVD STE 115",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481220",
            "telephone_number": "516-325-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NORTHERN BLVD STE 115",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481220",
            "telephone_number": "516-325-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Li Gastroenterology Endoscopy PC
• Diane Robin Lichtenberg-Scanlan, LCAT
• Jeremy Michael Liff, M.D.
• Irene C Lin, M.D.
• Samantha Lines, PA
• Long Island Lung Surgery PC
• Long Island Psychiatric, PLLC
• Hermes Lopez, MD
• Linda Marie Lopez, PH.D.
• Gina Luciano

• All providers in Greenvale, NY
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.