Individual provider Active NPI

Yolanda Li

  • Optometrist
  • Gallup, NM
National Provider Identifier
1275195315
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9696T Issued in TX
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9696T TX Primary

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191120000509 TX Practitioner - Optometry 0345672903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

007 Choosgai Dr
Tohatchi, NM 87325
Phone (505) 733-8413

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
61.12
Improvement activities
40
Cost
81.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9696TXMDChiropractor
9696TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation CurrentSince Sep 18, 2019 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Sep 18, 2019 Accepting new patients
Tuba City Regional Health Care Corporation Current Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Sep 27, 2020 Accepting new patients
DHHS, PHS, Naihs, Gallup Indian Medical Center CurrentSince Sep 27, 2020 Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 5

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1275195315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9696T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.