Individual provider Active NPI

Jie Liu, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1780066472
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A147758 Issued in CA
Practice address
302 Washington St # 201
San Diego, CA 92103-2110
Phone
(619) 438-4348
NPI assigned
Jun 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 A147758 CA Primary

Addresses

Primary practice location

302 Washington St # 201
San Diego, CA 92103-2110

Mailing address

302 Washington St # 201
San Diego, CA 92103-2110
Phone (619) 438-4348

Other identifiers 11

IdentifierTypeStateIssuer
036166709OtherILSTATE LICENSE
323476-01OtherNYSTATE LICENSE
EMC0003850OtherMISTATE LICENSE
MD61368889OtherWASTATE LICENSE
ME164158OtherFLSTATE LICENSE
CDR.03117OtherCOSTATE LICENSE
U6396OtherTXSTATE LICENSE
3415-320OtherWISTATE LICENSE
71292OtherAZSTATE LICENSE
25MA11856500OtherNJSTATE LICENSE
47156OtherALSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180622002224 CA Practitioner - General Practice 2264787878 Reassigns benefits to 1 organization
I20230818001152 NY Practitioner - Family Practice 2264787878

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147758CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners Colorado, PC CurrentSince Aug 21, 2023 Accepting new patients
Openloop Healthcare Partners PC CurrentSince Jun 20, 2023 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince May 29, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Openloop Healthcare Partners California PC Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince May 29, 2018 Accepting new patients
Openloop Healthcare Partners California PC CurrentSince Jul 3, 2023 Accepting new patients
Openloop Healthcare Partners New Jersey PC CurrentSince Jul 5, 2023 Accepting new patients

Locations

3707 E Southern Ave
Mesa, AZ 85206
Phone (480) 327-9103

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

2121 E Coast Hwy
Ste 270
Corona del Mar, CA 92625
Phone (949) 694-4937

72650 Fred Waring Dr
Ste 106
Palm Desert, CA 92260
Phone (760) 230-9990

5454 El Cajon Blvd
San Diego, CA 92115
Phone (619) 515-2381

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

1600 Broadway
Ste 1600
Denver, CO 80202
Phone (970) 592-8970

8270 Woodland Center Blvd
Tampa, FL 33614
Phone (305) 449-9219

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

1 Westbrook Corporate Ctr
Ste 300
Westchester, IL 60154
Phone (630) 709-1501

820 Bear Tavern Rd
Ewing, NJ 08628
Phone (415) 205-1229

101 Hudson St
Fl 21
Jersey City, NJ 07302
Phone (201) 706-7135

28 Liberty St
New York, NY 10005
Phone (415) 205-1229

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Interoperability endpoints

  • Direct secure messaging: jliu34750@scrippshlth.medalliesdirect.net

Organizations & group practices 8

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1780066472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 WASHINGTON ST # 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032110",
            "telephone_number": "619-438-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WASHINGTON ST # 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032110",
            "telephone_number": "619-438-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A147758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036166709",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "323476-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "EMC0003850",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD61368889",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME164158",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CDR.03117",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "U6396",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3415-320",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "71292",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MA11856500",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "47156",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.