Individual provider Active NPI

Xiaolong Sean Liu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Gainesville, FL
National Provider Identifier
1992782403
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME128535 Issued in FL
Practice address
6500 W Newberry Rd
Gainesville, FL 32605
Phone
(352) 333-4955
Fax
(352) 333-4284
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD20050608 NM
Hematology (Pathology) Physician 207ZH0000X MD20050608 NM
Immunopathology Physician 207ZI0100X MD20050608 NM
Anatomic Pathology Physician 207ZP0101X MD20050608 NM
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME128535 FL Primary

Addresses

Primary practice location

6500 W Newberry Rd
Gainesville, FL 32605

Mailing address

PO Box 741087
Atlanta, GA 30384-1087
Phone (352) 333-4955

Other practice location 1

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (561) 955-7100

Other identifiers 1

IdentifierTypeStateIssuer
52837MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160715002107 FL Practitioner - PathologyPractitioner - Hematology 5092891465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

6500 W Newberry Rd
Gainesville, FL 32605-4309
Phone (352) 333-4955

Hospital & facility affiliations

  • HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204
  • HCA Florida Lake City Hospital Hospital, Lake City, FL, CCN 100156

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
MD20050608NMMDHematology (Pathology) Physician
ME128535FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Nov 19, 2018 Accepting new patients

Locations

6500 W Newberry Rd
Gainesville, FL 32605
Phone (352) 333-4180

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

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.

Hospital & facility affiliations 2

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1992782403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841087",
            "telephone_number": "352-333-4955",
            "fax_number": "352-333-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-333-4955",
            "fax_number": "352-333-4284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Meadows Rd",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334862304",
            "country_code": "US",
            "telephone_number": "561-955-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "XIAOLONG",
        "middle_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NM",
            "license": "MD20050608",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "NM",
            "license": "MD20050608",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "NM",
            "license": "MD20050608",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NM",
            "license": "MD20050608",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME128535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52837",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.