Active NPI
Bolun Liu, MD
- Internal Medicine Physician
- Mankato, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125071677
- Practice address
- 1025 Marsh St
Mankato, MN 56001 - Phone
- (507) 625-4031
- NPI assigned
- Jul 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125071677 | IL | Primary |
Addresses
Primary practice location
1025 Marsh St
Mankato, MN 56001
Mailing address
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Other practice location 1
1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210518000328 | MN | Practitioner - Internal Medicine | 0547514473 | Reassigns benefits to 10 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mayo Clinic Health System-Southwest Minnesota Region
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Hospital & facility affiliations
- Mayo Clinic Health System - Mankato
- Mayo Clinic Health System St. James
- Mayo Clinic Health System - Albert Lea and Austin
- North Memorial Health Hospital
- Owatonna Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
Locations
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351
32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
501 State St N
Waseca, MN 56093
Phone (507) 835-1210
Organizations & group practices 17
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.
-
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
MN
-
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
MN
-
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
MN
-
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
MN
-
- Multi-Specialty Clinic/Center
- Albert Lea, MN
- NPI 1891701637
MN
-
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
-
- Medicare Defined Swing Bed Hospital Unit
- New Prague, MN
- NPI 1487707832
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Owatonna, MN
- NPI 1619911179
Hospital
-
- General Acute Care Hospital
- Albert Lea, MN
- NPI 1346258100
Hospital
-
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1861988511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-625-4031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "56001",
"telephone_number": "507-625-4031"
}
],
"practiceLocations": [
{
"address_1": "1901 W Harrison St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606123714",
"country_code": "US",
"telephone_number": "312-864-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "BOLUN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-05",
"last_updated": "2023-12-19",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125071677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.