Individual provider Active NPI

Charlene Ashley Liao, MD

  • Family Medicine Physician
  • Fairfield, CT
National Provider Identifier
1700414042
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75746 Issued in CT
Practice address
1152 Kings Highway Cutoff
Fairfield, CT 06824-5271
Phone
(203) 256-5500
Fax
(203) 255-0046
NPI assigned
Mar 31, 2020
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 75746 CT Primary

Addresses

Primary practice location

1152 Kings Highway Cutoff
Fairfield, CT 06824-5271

Mailing address

1152 Kings Highway Cutoff
Fairfield, CT 06824-5271
Phone (203) 256-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230922000914 CT Practitioner - Family Practice 8628422896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Practice addresses (Care Compare)

1152 Kings Hwy Cutoff
Fairfield, CT 06824-5271
Phone (203) 256-5500

222 Post Rd
Suite E
Fairfield, CT 06824-6245
Phone (203) 255-8888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Oct 2, 2023 Accepting new patients

Locations

1152 Kings Highway Cutoff
Fairfield, CT 06824
Phone (203) 256-5500

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: cliao632752@direct.ynhh.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1700414042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 KINGS HIGHWAY CUTOFF",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245271",
            "telephone_number": "203-256-5500",
            "fax_number": "203-255-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 KINGS HIGHWAY CUTOFF",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245271",
            "telephone_number": "203-256-5500",
            "fax_number": "203-255-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAO",
        "first_name": "CHARLENE",
        "middle_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "75746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.