NPIMap

Individual provider Active NPI

Changxin Li, M.D.

  • Internal Medicine Physician
  • Gaylord, MI
National Provider Identifier
1114958899
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301058124 Issued in MI
Practice address
829 N Center Ave
Suite 140
Gaylord, MI 49735-1595
Phone
(989) 731-7870
Fax
(989) 731-7837
NPI assigned
Jul 5, 2006
Last updated
Dec 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301058124 MI Primary

Addresses

Primary practice location

829 N Center Ave
Suite 140
Gaylord, MI 49735-1595

Mailing address

829 N Center Ave
Suite 298
Gaylord, MI 49735-1595
Phone (989) 731-7708

Other identifiers 5

IdentifierTypeStateIssuer
1106900352OtherMIBCBSM PROVIDER NUMBER
381303843OtherTAX ID
11281960OtherCAQH PROVIDER ID
4299165MedicaidMI
DC6209OtherMEDICARE RR PROV ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000347 MI Practitioner - Internal Medicine 5395888978 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northsport Physical Therapy and Rehabilitation P CGroup PAC ID 5294902508, shared by 2 NPIs, 43 clinicians
Otsego Physician Services PCGroup PAC ID 7416468954, 35 clinicians

Practice addresses (Care Compare)

1622 Dickerson Rd
Gaylord, MI 49735-9206

825 N Ctr Ave
Gaylord, MI 49735-1592
Phone (989) 731-2100

829 N Ctr Ave
140 MHC Omh Medical Group Internal Med.
Gaylord, MI 49735-1598
Phone (989) 731-7870

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Otsego Physician Services PC Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Apr 13, 2000 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Apr 13, 2000 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Past Accepting new patients
Petoskey Surgeons, P.C. Past Accepting new patients

Locations

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 140
Gaylord, MI 49735
Phone (989) 731-7860

829 N Center Ave
Ste 200
Gaylord, MI 49735
Phone (989) 731-2105

829 N Center Ave
Ste 298
Gaylord, MI 49735
Phone (989) 731-7707

Interoperability endpoints

  • Direct secure messaging: cli222@direct.mhc.net

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1114958899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 298",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7708",
            "fax_number": "989-731-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 140",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7870",
            "fax_number": "989-731-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "CHANGXIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PROVIDER NUMBER",
            "identifier": "1106900352",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "381303843",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11281960",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4299165",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PROV ID",
            "identifier": "DC6209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.