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DR. ZACHARY JONATHAN LISS M.D. NPI 1457592990


NPI Information

NPI: 1457592990
Provider Name: DR. ZACHARY JONATHAN LISS, M.D.
Classification: Urology - 2088P0231X
Entity Type: Individual

Specialization: Pediatric Urology

PECOS Registration: Yes

Address:
20952 E 12 MILE RD
SUITE 200
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (586) 771-4820
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DR. Zachary Jonathan Liss, M.D. is a pediatric urology urology in Saint Clair Shores, MI. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). DR. Zachary Jonathan Liss, M.D. NPI is 1457592990. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20952 E 12 MILE RD
SUITE 200
SAINT CLAIR SHORES, MI
ZIP 48081-200
Phone: (586) 771-4820

The NPI 1457592990 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/12/2009 and was last updated on 8/6/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrology4301092867MICHIGANNo
22088P0231XUrologyPediatric Urology4301092867MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CB9133OTHERMICHIGANRAILROAD MEDICARE
20E06273075MEDICARE PINMICHIGAN
3340E062730OTHERMICHIGANBCBSM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.