NPIMap

Individual provider Active NPI

Kaixuan Liu, M.D

  • Interventional Pain Medicine Physician
  • West Orange, NJ
National Provider Identifier
1801815287
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MA07186700 Issued in NJ
Practice address
475 Prospect Ave Suite 110
West Orange, NJ 07052
Phone
(973) 419-0200
Fax
(973) 419-0223
NPI assigned
Jul 18, 2006
Last updated
Sep 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 25MA07186700 NJ Primary

Addresses

Primary practice location

475 Prospect Ave Suite 110
West Orange, NJ 07052

Mailing address

475 Prospect Ave. Suite 110
West Orange, NJ 07052
Phone (973) 419-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2012 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07189700NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Garden State Orthopedic and Spine Associates LLC PastSince Feb 11, 2016 Accepting new patients
Windber Hospital, Inc. Interventional Pain Medicine Past Accepting new patients
Advanced Spine Surgery Center, LLC PastSince Feb 22, 2017 Accepting new patients
Rancocas Anesthesiology, P.a. Past Accepting new patients
Monmouth Anesthesia Associates Past Accepting new patients
Park Avenue Ambulatory Medical PC Past Accepting new patients
Ocean Perioperative Consultants P.a. Past Accepting new patients
Specialty Anesthesia Associates, LLC Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1801815287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE. SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-419-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE SUITE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-419-0200",
            "fax_number": "973-419-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "KAIXUAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA07186700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.