Individual provider Active NPI

Tony Li, DPT

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1457691198
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035677-1 Issued in NY
Practice address
96 Coles St Apt 3
Jersey City, NJ 07302-2144
Phone
(917) 292-0193
NPI assigned
Feb 17, 2013
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 035677-1 NY Primary

Addresses

Primary practice location

96 Coles St Apt 3
Jersey City, NJ 07302-2144

Mailing address

96 Coles St Apt 3
Jersey City, NJ 07302-2144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035677-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Physical Therapy Solutions P.C. Physical Therapist CurrentSince Feb 23, 2012 Accepting new patients
Bravo Occupational Therapy PC Physical Therapist PastSince Feb 21, 2013 Accepting new patients
Sovereign Medical Group LLC PastSince Sep 17, 2017 Accepting new patients

Locations

111 W Old Country Rd
Unit 1
Hicksville, NY 11801
Phone (516) 433-4570

1865 Amsterdam Ave
Lowr
New York, NY 10031
Phone (212) 567-5191

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

NPI Registry JSON

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

{
    "created_epoch": "1361059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1457691198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 COLES ST APT 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 COLES ST APT 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022144",
            "telephone_number": "917-292-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "TONY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-17",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035677-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.