Individual provider Active NPI

Shifan Li, MD

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1306219712
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
990 South Ave Ste 207
Rochester, NY 14620-2762
Phone
(585) 341-6775
Fax
(585) 341-8310
NPI assigned
Nov 6, 2015
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

990 South Ave Ste 207
Rochester, NY 14620-2762

Mailing address

990 South Ave Ste 207
Rochester, NY 14620-2762
Phone (856) 236-4893

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526000343 NY Practitioner - Internal Medicine 0547685026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Cooper Medical School of Rowan University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Observation Associates of the University of RochesterGroup PAC ID 7517919244, 39 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-0980

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates - University of Rochester CurrentSince Jul 1, 2023 Accepting new patients
Observation Associates of the University of Rochester CurrentSince Jul 1, 2023 Accepting new patients
University of Rochester Past Accepting new patients
New Life Counseling & Wellness Center, Inc. Mental Health Past Accepting new patients

Locations

156 West Ave
Brockport, NY 14420
Phone (585) 395-6095

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1306219712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SOUTH AVE STE 207",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202762",
            "telephone_number": "856-236-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SOUTH AVE STE 207",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202762",
            "telephone_number": "585-341-6775",
            "fax_number": "585-341-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "SHIFAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.