JIM LIAO (PA) – Surgical Physician Assistant, NPI 1023033552

JIM LIAO (PA) is a healthcare provider. based in Los angeles, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA16667 (CA). The NPI Number for JIM LIAO (PA) is 1023033552

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
JIM LIAO (PA)
NPI
1023033552
Phone
(310) 825-5111
Address
5767 W CENTURY BLVD
Enumeration Date
13 July 2006
Last Update Date
26 July 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
1254523608
Group Practice PAC ID
1355249491
Professional Enrollment ID
I20101005000059
Address ID
CA900958358LO757XXPLZX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

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Provider Addresses for JIM LIAO (PA)

  • 5767, West Century Boulevard, Westchester, Los Angeles, Los Angeles County, California, 90045, United States

    SUITE 400

    LOS ANGELES, CA 900455631

    Phone: (310) 825-5111

    Type: Mailing

  • Wendy and Leonard Goldberg Medical Building, 300, Medical Plaza Driveway, Westwood, Los Angeles, Los Angeles County, California, 90095, United States

    STE 400

    LOS ANGELES, CA 900950001

    Phone: (310) 825-5111

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $29.

Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Medtronic, Inc. ($29).

Total Amount

$29

General + Research + Ownership

Payments

1

Total payment records

General Amount

$29

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$29
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101005000059IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90045)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355249491View full group profile
NameSpecialtyState
Neurology, Critical Care (Intensivists)CA
N E U R O S U R G E R YCA
N E U R O S U R G E R YCA
N E U R O S U R G E R YCA
Nurse PractitionerCA
N E U R O S U R G E R YCA
Nurse PractitionerCA
N E U R O S U R G E R YCA
Physical Medicine And RehabilitationCA
N E U R O S U R G E R YCA

Reviews

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Frequently asked questions

What unique ID ties claims to JIM LIAO (PA)?
NPI 1023033552 is assigned to JIM LIAO (PA) under the national enumeration system.
Is JIM LIAO (PA) currently active in the NPI registry?
CMS-published data lists JIM LIAO (PA) as an active registrant.
Can you summarize JIM LIAO (PA)'s specialty in plain language?
Clinically, the directory lists JIM LIAO (PA) with Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is JIM LIAO (PA)'s primary listing?
We display Los Angeles, California because that is what the record indicates for JIM LIAO (PA).
Is JIM LIAO (PA) a real provider?
This page reflects official NPPES data for NPI 1023033552. Always confirm identity and privileges with the practice and licensing boards.

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