Individual provider Active NPI

Terry C. Liu, M.D.

  • Otolaryngology Physician
  • Kenosha, WI
National Provider Identifier
1841212115
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
41163 Issued in WI
Practice address
1020 35TH St
Kenosha, WI 53140-1932
Phone
(262) 652-3500
NPI assigned
Jul 24, 2006
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 41163 WI Primary

Addresses

Primary practice location

1020 35TH St
Kenosha, WI 53140-1932

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
32570700MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tliu42426@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070320000212 WI Practitioner - Otolaryngology 0042313694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 35TH St
Kenosha, WI 53140-1932
Phone (262) 652-3500

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone (262) 857-5000

13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000

248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41163WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince May 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 1, 2009 Accepting new patients
Visiting Nurse Association of Wisconsin, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

10117 74th St
Ste 110
Kenosha, WI 53142
Phone (262) 697-1919

1020 35th St
Kenosha, WI 53140
Phone (262) 652-3500

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

7550 22nd Ave
Kenosha, WI 53143
Phone (262) 658-2500

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000

Interoperability endpoints

  • Direct secure messaging: tliu42426@direct.myadvocateaurora.org

Organizations & group practices 4

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 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1841212115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401932",
            "telephone_number": "262-652-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "TERRY",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "41163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32570700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tliu42426@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.