Individual provider Active NPI

Jay Lawrence Liss, M.D.

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1679584494
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30759 Issued in MO
Practice address
8711 Watson Rd
Suite 100
Saint Louis, MO 63119-5100
Phone
(314) 961-9871
Fax
(314) 961-9877
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 30759 MO Primary

Addresses

Primary practice location

8711 Watson Rd
Suite 100
Saint Louis, MO 63119-5100

Mailing address

8711 Watson Rd
Suite 100
Saint Louis, MO 63119-5100
Phone (314) 961-9871

Other identifiers 2

IdentifierTypeStateIssuer
200765907MedicaidMO
916745640OtherMOMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040512000890 MO Practitioner - Psychiatry 7416947502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Washington University School of Medicine, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8711 Watson Rd
Suite 100
Saint Louis, MO 63119-5100
Phone (317) 961-9871

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30759MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Psychiatry, LLC Psychiatry CurrentSince Jan 1, 2024 Accepting new patients
Jay L. Liss, Incorporated CurrentSince May 12, 2004 Accepting new patients
Liss & Assoc., Inc. CurrentSince Feb 27, 1995 Accepting new patients

Locations

8711 Watson Rd
Ste 100
Saint Louis, MO 63119
Phone (314) 569-0212

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1679584494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 WATSON RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195100",
            "telephone_number": "314-961-9871",
            "fax_number": "314-961-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8711 WATSON RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195100",
            "telephone_number": "314-961-9871",
            "fax_number": "314-961-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "JAY",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "30759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200765907",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "916745640",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.