Mr Jeremy D Liu, PA-C is a medicare enrolled "Physician Assistant" physician in Fort Worth, Texas. His current practice location is
815 Pennsylvania Ave, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 321-0404.
Mr Jeremy D Liu is licensed to practice in Texas (license number PA19003) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1518774777.
Physician's Profile
| Full Name | Mr Jeremy D Liu |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 815 Pennsylvania Ave, Fort Worth, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1518774777
- Provider Enumeration Date: 12/11/2024
- Last Update Date: 06/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 6406374164
- Enrollment ID: I20250516000063
Medical Identifiers
Medical identifiers for Mr Jeremy D Liu such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1518774777 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 0 (Texas) | Secondary |
| 363A00000X | Physician Assistant | PA19003 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jeremy D Liu is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mr Jeremy D Liu, PA-C 1320 S University Dr Ste 500, Fort Worth, TX 76107-5732 Ph: (817) 321-0404 | Mr Jeremy D Liu, PA-C 815 Pennsylvania Ave, Fort Worth, TX 76104-2294 Ph: (817) 321-0404 |
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