Individual provider Active NPI

Michelle Liu, MD

  • Ophthalmology Physician
  • Walnut Creek, CA
National Provider Identifier
1700802451
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A73072 Issued in CA
Practice address
1844 San Miguel Dr
#303
Walnut Creek, CA 94596-4962
Phone
(925) 930-8100
Fax
(925) 945-7458
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A73072 CA Primary

Addresses

Primary practice location

1844 San Miguel Dr
#303
Walnut Creek, CA 94596-4962

Mailing address

1844 San Miguel Dr
#303
Walnut Creek, CA 94596-4962

Other identifiers 1

IdentifierTypeStateIssuer
00A730720MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040219000649 CA Practitioner - Ophthalmology 6800781667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73072CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
John Muir Trauma Physicians Billing Service Ophthalmology CurrentSince Jul 1, 2018 Accepting new patients

Locations

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1700802451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR",
            "address_2": "#303",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR",
            "address_2": "#303",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964962",
            "telephone_number": "925-930-8100",
            "fax_number": "925-945-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A73072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A730720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.