Individual provider Active NPI

Evan Liu, DO

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1740869957
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
340418 Issued in NY
Practice address
104 Delancey St
New York, NY 10002-3202
Phone
(212) 677-2157
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 340418 NY Primary

Addresses

Primary practice location

104 Delancey St
New York, NY 10002-3202

Mailing address

104 Delancey St
New York, NY 10002-3202
Phone (212) 677-2157

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216002866 NY Practitioner - Family Practice 2062907157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

104 Delancey St
New York, NY 10002-3202
Phone (212) 655-2157

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2026 Accepting new patients

Locations

104 Delancey St
New York, NY 10002
Phone (212) 533-5090

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1740869957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DELANCEY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100023202",
            "telephone_number": "212-677-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DELANCEY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100023202",
            "telephone_number": "212-677-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "340418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.