Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jared Michael Liston, MD

Individual provider Plastic Surgery Physician · NPI 1932630019

Jared Michael Liston, MD is a Plastic and Reconstructive Surgery in Charlottesville, Virginia. Graduated from Wright State University Boonshoft School of Medicine in 2017, 9 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
9
Trained at
Wright State University Boonshoft School of Medicine
Licensed in
VA
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1215 Lee St Box #800376
Charlottesville, VA 22908-0816
Phone: (434) 924-5078
Fax: (434) 924-8118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 0101280287 (VA)

Record details

NPI number1932630019
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2017
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024
Mailing address1215 Lee St, Box #800376, Charlottesville, VA 22908-0816

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolWRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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