Individual provider Active NPI

Jeng-Jong Liao, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Monterey Park, CA
National Provider Identifier
1851442057
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
C50014 Issued in CA
Practice address
500 N Garfield Ave Ste 204
Monterey Park, CA 91754-1242
Phone
(626) 280-4393
NPI assigned
Jan 15, 2007
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X C50014 CA Primary
Pulmonary Disease Physician 207RP1001X C50014 CA

Addresses

Primary practice location

500 N Garfield Ave Ste 204
Monterey Park, CA 91754-1242

Mailing address

500 N Garfield Ave Ste 204
Monterey Park, CA 91754-1242
Phone (626) 280-4393

Other identifiers 1

IdentifierTypeStateIssuer
00C500140MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100525000988 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8921141102 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Temple University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 N Garfield Ave
Monterey Park, CA 91754-1242
Phone (626) 280-4393

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C50014CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeng-Jong Liao MD Inc Critical Care Medicine CurrentSince Apr 15, 2020 Accepting new patients
Prestige Pulmonary Consultants Inc Critical Care Medicine CurrentSince May 1, 2020 Accepting new patients

Locations

500 N Garfield Ave
Ste 204
Monterey Park, CA 91754
Phone (626) 280-4393

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1851442057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 204",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-280-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 204",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-280-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAO",
        "first_name": "JENG-JONG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "C50014",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C50014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C500140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.