NPIMap

Individual provider Active NPI

Xin-Nong Li, MD

  • Internal Medicine Physician
  • Fair Oaks, CA
National Provider Identifier
1205804036
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A067508 Issued in CA
Practice address
6600 Mercy CT
Ste 130
Fair Oaks, CA 95628-3158
Phone
(916) 961-3084
Fax
(916) 961-3018
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 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 A067508 CA Primary

Addresses

Primary practice location

6600 Mercy CT
Ste 130
Fair Oaks, CA 95628-3158

Mailing address

6600 Mercy CT
Ste 130
Fair Oaks, CA 95628-3158
Phone (916) 961-3084

Other identifiers 1

IdentifierTypeStateIssuer
00A675080MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070716000760 CA Practitioner - Internal Medicine 6901906205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6600 Mercy CT
Suite 130
Fair Oaks, CA 95628-3154
Phone (916) 961-3084

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A067508CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Xin-Nong Li M.D., Inc. Internal Medicine CurrentSince Sep 21, 2009 Accepting new patients
Dignity Health Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Valley Medical Foundation Past Accepting new patients

Locations

6600 Mercy Ct
Ste 130
Fair Oaks, CA 95628
Phone (916) 961-3084

6600 Mercy Ct
Ste 130FAIR
Fair Oaks, CA 95628

Organizations & group practices 4

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

Hospital & facility affiliations 7

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1205804036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 MERCY CT",
            "address_2": "STE 130",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283158",
            "telephone_number": "916-961-3084",
            "fax_number": "916-961-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 MERCY CT",
            "address_2": "STE 130",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283158",
            "telephone_number": "916-961-3084",
            "fax_number": "916-961-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "XIN-NONG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A067508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A675080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.