NPIMap

Individual provider Active NPI

Guanqun Li

  • Urology Physician
  • Honesdale, PA
National Provider Identifier
1477014496
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD485587 Issued in PA
Practice address
601 Park St # 1445
Honesdale, PA 18431-1445
Phone
(570) 253-8100
NPI assigned
Mar 31, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD485587 PA Primary

Addresses

Primary practice location

601 Park St # 1445
Honesdale, PA 18431-1445

Mailing address

32 Presidential CTS
Syracuse, NY 13202-2477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913000342 PA Practitioner - Urology 6204376593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne Memorial HospitalGroup PAC ID 4082522149, 52 clinicians

Practice addresses (Care Compare)

601 Park St
Honesdale, PA 18431-1445
Phone (570) 253-8101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Prostate resection26
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD485587PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital CurrentSince Jul 8, 2024 Accepting new patients
Wayne Memorial Hospital Urology CurrentSince Jul 8, 2024 Accepting new patients

Locations

601 Park St
#1445
Honesdale, PA 18431
Phone (570) 253-8100

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

1400 Main St
Peckville, PA 18452
Phone (570) 307-7600

Interoperability endpoints

  • Direct secure messaging: guanqun.li.1@30200.direct.athenahealth.com

Organizations & group practices 2

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 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1477014496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PRESIDENTIAL CTS",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PARK ST # 1445",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311445",
            "telephone_number": "570-253-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "GUANQUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD485587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

Verify at the official NPI Registry.