Individual provider Active NPI

Elizabeth Tien, M.D.

  • Child & Adolescent Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1851554364
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
170465 Issued in CA
Practice address
1720 E 120TH St
Los Angeles, CA 90059-3052
Phone
(310) 668-4272
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 256438 NY
Child & Adolescent Psychiatry Physician 2084P0804X 170465 CA Primary

Addresses

Primary practice location

1720 E 120TH St
Los Angeles, CA 90059-3052

Mailing address

1720 E 120TH St
Los Angeles, CA 90059-3052

Other practice location 1

577 1st Ave
New York, NY 10016-6404
Phone (212) 263-6622

Other practice location 2

268 Canal St
New York, NY 10013-3599
Phone (212) 941-2213

Other identifiers 1

IdentifierTypeStateIssuer
03477176MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 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
I20120720000230 NY Practitioner - Psychiatry 6406012376 Reassigns benefits to 2 organizations
I20220823002369 CA Practitioner - Psychiatry 6406012376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1720 E 120TH St
Los Angeles, CA 90058-3052
Phone (310) 668-4803

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170465CAMDChild & Adolescent Psychiatry Physician
256438NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Department of Psychiatry FPP CurrentSince Jul 1, 2012 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Maimonides Medical Center Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 11, 2022 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jun 7, 2012 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 11, 2022 Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients

Locations

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

1720 E 120th St
Los Angeles, CA 90059
Phone (310) 668-4272

3741 Stocker St
Ste 200
View Park, CA 90008
Phone (323) 290-5800

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

Interoperability endpoints

  • Direct secure messaging: elizabethtien@mai.allscriptsdirect.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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1851554364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E 120TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593052",
            "telephone_number": "310-668-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "577 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166404",
            "country_code": "US",
            "telephone_number": "212-263-6622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "268 Canal St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100133599",
            "country_code": "US",
            "telephone_number": "212-941-2213",
            "fax_number": "212-941-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEN",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "256438",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "170465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03477176",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.