Individual provider Active NPI

Siyu Li, PA-C

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1316588148
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
19742 Macarthur Blvd Ste 250
Irvine, CA 92612-2488
Phone
(714) 503-6550
Fax
(714) 409-3075
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

19742 Macarthur Blvd Ste 250
Irvine, CA 92612-2488

Mailing address

19742 Macarthur Blvd Ste 250
Irvine, CA 92612-2488
Phone (714) 503-6550

Other practice location 1

451 W Lincoln Ave Ste 100
Anaheim, CA 92805-2912
Phone (714) 503-6550

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
I20240624001580 CA Practitioner - Physician Assistant 5698190163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
KCS, Inc. CurrentSince Jun 10, 2024 Accepting new patients
Beach Physicians Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients
KCS, Inc. CurrentSince Jun 10, 2024 Accepting new patients

Locations

451 W Lincoln Ave
Ste 100
Anaheim, CA 92805
Phone (714) 507-3770

17742 Beach Blvd
Ste 215
Huntington Beach, CA 92647
Phone (714) 848-1655

19742 MacArthur Blvd
Ste 250
Irvine, CA 92612
Phone (949) 486-8530

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: siyu.li.p1@direct.kcs.nextgenshare.com

Organizations & group practices 3

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1316588148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122488",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122488",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 W Lincoln Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928052912",
            "country_code": "US",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "SIYU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.