Individual provider Active NPI

Jason Liu

  • Physical Therapist
  • Chino Hills, CA
National Provider Identifier
1972858348
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296360 Issued in CA
Practice address
13353 Cardinal Ridge Rd Unit E
Chino Hills, CA 91709
Phone
(301) 908-0697
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 24122 MD
Physical Therapist 225100000X 296360 CA Primary

Addresses

Primary practice location

13353 Cardinal Ridge Rd Unit E
Chino Hills, CA 91709

Mailing address

13353 Cardinal Ridge Rd Unit E
Chino Hills, CA 91709-1279
Phone (301) 908-0697

Other practice location 1

3300 Olney Sandy Spring Rd
Olney, MD 20832-1494
Phone (301) 260-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260516000460 DC Practitioner - Physical Therapist in Private Practice 6204201312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24122MDMDPhysical Therapist

Organizations & group practices 1

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1972858348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13353 CARDINAL RIDGE RD UNIT E",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091279",
            "telephone_number": "301-908-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13353 CARDINAL RIDGE RD UNIT E",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "91709",
            "telephone_number": "301-908-0697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Olney Sandy Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "MD",
            "postal_code": "208321494",
            "country_code": "US",
            "telephone_number": "301-260-8383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24122",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.