Active NPI
Lydia Liu
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1609364116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 182663
- Practice address
- 1019 Gayley Ave FL 2
Los Angeles, CA 90024-3437 - Phone
- (917) 821-1281
- NPI assigned
- Apr 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 182663 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1019 Gayley Ave FL 2
Los Angeles, CA 90024-3437
Mailing address
6 Bradley CT Apt 4S
Mineola, NY 11501-3708
Phone (917) 821-1281
Other practice location 1
Mount Sinai West
1000 10th Ave
New York, NY 10019
Phone (212) 523-4000
Other practice location 2
6 Bradley Ct Apt 4S
Mineola, NY 11501-3708
Phone (917) 821-1281
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190115001556 | NY | Order and Referring Only - Psychiatry | 9133465958 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 182663 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1609364116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 BRADLEY CT APT 4S",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013708",
"telephone_number": "917-821-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 GAYLEY AVE FL 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900243437",
"telephone_number": "917-821-1281"
}
],
"practiceLocations": [
{
"address_1": "Mount Sinai West",
"address_2": "1000 10th Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10019",
"country_code": "US",
"telephone_number": "212-523-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6 Bradley Ct Apt 4S",
"address_purpose": "LOCATION",
"city": "Mineola",
"state": "NY",
"postal_code": "115013708",
"country_code": "US",
"telephone_number": "917-821-1281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "LYDIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "182663",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.