JESSICA LIU – Physician Assistant, NPI 1164233607

JESSICA LIU is a healthcare provider. based in Plymouth, Minnesota. specializing in PHYSICIAN ASSISTANT. The NPI Number for JESSICA LIU is 1164233607

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA LIU
NPI
1164233607
Phone
(763) 504-6600
Address
1495 COUNTY ROAD 101 N
Enumeration Date
15 January 2025
Last Update Date
19 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635046500
Graduation Year
2024 (2 years ago)
PAC ID
0547787822
Group Practice PAC ID
0042102956
Professional Enrollment ID
I20250509001322
Address ID
MN554473078PL1495X101X400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness85
Years active:1State licenses:0Digital endpointsOther names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for JESSICA LIU

  • 1495 COUNTY ROAD 101 N

    PLYMOUTH, MN 554473078

    Phone: (763) 504-6600

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-05-09

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
I20250509001322IPhysician AssistantMNTBD

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 55447)

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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: 0042102956View full group profile

Reviews

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Frequently asked questions

Can I verify JESSICA LIU with an NPI only?
You can start verification with NPI 1164233607 for JESSICA LIU, then check state licensing separately.
Can I rely on JESSICA LIU being an active provider?
As of the registry snapshot, JESSICA LIU is marked active.
What taxonomy line describes JESSICA LIU?
For research purposes, treat JESSICA LIU as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for JESSICA LIU?
JESSICA LIU's geographic hint is Plymouth, Minnesota in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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