Individual provider Active NPI

Audrey Chen Li

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1235940131
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
60 N 36TH St
Philadelphia, PA 19104-5639
Phone
(215) 895-2000
NPI assigned
Jan 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

60 N 36TH St
Philadelphia, PA 19104-5639

Mailing address

60 N 36TH St
Philadelphia, PA 19104-5639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125000778 CA Practitioner - Physician Assistant 4486146628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 S Beach Blvd
Suite C
Anaheim, CA 92804-1812

60 N 36TH St
Philadelphia, PA 19104-5639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tahmina Haq MD CurrentSince Sep 13, 2025 Accepting new patients

Locations

631 S Brookhurst St
Ste 214
Anaheim, CA 92804
Phone (714) 545-5200

515 S Beach Blvd
Ste C
Anaheim, CA 92804
Phone (714) 527-9006

801 N Tustin Ave
Ste 700
Santa Ana, CA 92705
Phone (714) 541-4185

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCIADD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1235940131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N 36TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N 36TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045639",
            "telephone_number": "215-895-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "AUDREY",
        "middle_name": "CHEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.