| Dr Liza Antoinette Jain Phu, MD | |
|
265 Creek Ln S, Jordan, MN 55352-1214 | |
| (952) 428-1200 | |
| (952) 428-1201 |
| Full Name | Dr Liza Antoinette Jain Phu |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 18 Years |
| Location | 265 Creek Ln S, Jordan, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174758908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 60116222 (Washington) | Secondary |
| 207Q00000X | Family Medicine | 036.129032 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 53359 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Francis Regional Medical Center | Shakopee, MN | Hospital |
| Abbott Northwestern Hospital | Minneapolis, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Allina Health System | 4587573613 | 3584 |
| St Francis Regional Medical Center | 7214821909 | 96 |
| Entity Name | St Francis Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447605514 PECOS PAC ID: 7214821909 Enrollment ID: O20040212000408 |
| Entity Name | Allina Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295272342 PECOS PAC ID: 4587573613 Enrollment ID: O20040319000460 |
| Entity Name | Allina Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457657249 PECOS PAC ID: 4587573613 Enrollment ID: O20221213001713 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Liza Antoinette Jain Phu, MD 2925 Chicago Ave, Minneapolis, MN 55407-1321 Ph: (612) 262-5000 | Dr Liza Antoinette Jain Phu, MD 265 Creek Ln S, Jordan, MN 55352-1214 Ph: (952) 428-1200 |
Dr. Josiah A. Goldammer, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 265 Creek Ln S, Jordan, MN 55352 Phone: 952-428-1200 | |
Dr. Rebecca Rae Kragh, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3976 Golfview Dr, Jordan, MN 55352 Phone: 952-492-5649 Fax: 952-492-5650 |