Individual provider Active NPI

Stephanie Liu, PA

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1720657638
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110007808 Issued in VA
Practice address
8501 Arlington Blvd Ste 410
Fairfax, VA 22031-4632
Phone
(703) 738-4331
NPI assigned
Jun 24, 2021
Last updated
Mar 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110007808 VA Primary

Addresses

Primary practice location

8501 Arlington Blvd Ste 410
Fairfax, VA 22031-4632

Mailing address

11350 McCormick Rd
Executive Plaza 1, Ste. 501
Hunt Valley, MD 21031
Phone (703) 914-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sliu1@spineandpain.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210728000599 DC Practitioner - Physician Assistant 2466855481 Reassigns benefits to 1 organization
I20210929003264 VA Practitioner - Physician Assistant 2466855481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine Associates LTDGroup PAC ID 4981688835, 73 clinicians

Practice addresses (Care Compare)

14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3337
Phone (703) 738-4371

6355 Walker LN
Suite 507
Alexandria, VA 22310-3251
Phone (703) 971-4604

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110007808VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Associates LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sliu1@spineandpain.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1720657638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "EXECUTIVE PLAZA 1, STE. 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031",
            "telephone_number": "703-914-8000",
            "fax_number": "410-329-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 ARLINGTON BLVD STE 410",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314632",
            "telephone_number": "703-738-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sliu1@spineandpain.emadirect.md",
            "affiliation": "N",
            "address_1": "8501 Arlington Blvd Ste 410",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.