Individual provider Active NPI

Kevin Xiaobo Liu, MD

  • Diagnostic Radiology Physician
  • Addison, TX
National Provider Identifier
1881030617
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
S0009 Issued in TX
Practice address
4450 Sojourn Dr Ste 200
Addison, TX 75001-5000
Phone
(972) 733-0014
Fax
(972) 733-0125
NPI assigned
May 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2017043385 MO
Diagnostic Radiology Physician 2085R0202X S0009 TX Primary

Addresses

Primary practice location

4450 Sojourn Dr Ste 200
Addison, TX 75001-5000

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 1

IdentifierTypeStateIssuer
398424705MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190625003726 TX Practitioner - Diagnostic Radiology 2668693748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Radiology Consultants PLLCGroup PAC ID 6709868409, 120 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-3216

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
  • Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017043385MOMDDiagnostic Radiology Physician
S0009TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Btdi JV LLP CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV, LLP CurrentSince Jun 28, 2019 Accepting new patients
Btdi JV LLP CurrentSince Nov 25, 2021 Accepting new patients
Btdi JV LLP CurrentSince Jan 1, 2023 Accepting new patients
American Radiology Consultants PLLC Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV LLP CurrentSince Jun 28, 2019 Accepting new patients
Btdi JV LLP CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV, LLP CurrentSince Aug 18, 2021 Accepting new patients
Btdi JV LLP CurrentSince Jan 1, 2023 Accepting new patients
Blue Stone JV LLP CurrentSince Apr 1, 2023 Accepting new patients
Btdi JV LLP CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV LLP CurrentSince Nov 25, 2021 Accepting new patients
Btdi JV LLP CurrentSince Sep 30, 2023 Accepting new patients
Btdi JV, LLP CurrentSince Nov 1, 2023 Accepting new patients
Btdi JV LLP CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV LLP CurrentSince Oct 1, 2024 Accepting new patients
Btdi JV LLP CurrentSince Jul 1, 2019 Accepting new patients
Btdi JV LLP CurrentSince Mar 1, 2024 Accepting new patients

Locations

4450 Sojourn Dr
Ste 200
Addison, TX 75001
Phone (469) 850-5760

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

712 N Washington Ave
Ste 102
Dallas, TX 75246
Phone (214) 515-0016

3500 Gaston Ave
Dallas, TX 75246

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Organizations & group practices 18

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.

View all 18

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1881030617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 SOJOURN DR STE 200",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750015000",
            "telephone_number": "972-733-0014",
            "fax_number": "972-733-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "KEVIN",
        "middle_name": "XIAOBO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2017043385",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "S0009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "398424705",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.