Organization Active NPI

Michael Li MD PLLC

  • Specialist
  • Flushing, NY
National Provider Identifier
1508891508
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2148511 Issued in NY
Legal business name
MICHAEL LI MD PLLC
Practice address
13620 38TH Ave
Suite 6F
Flushing, NY 11354-4233
Phone
(718) 888-9700
Fax
(718) 888-9796
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Michael Li, MD PHDNPI 1770547630
Title
Doctor
Phone
(718) 888-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 2148511 NY Primary

Addresses

Primary practice location

13620 38TH Ave
Suite 6F
Flushing, NY 11354-4233

Mailing address

136-20 38 Ave
Suite 6F
Flushing, NY 11354-4263
Phone (718) 888-9700

Other identifiers 1

IdentifierTypeStateIssuer
02213427MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601000720 NY Part B Supplier - Clinic/Group Practice 5799772935 Receives reassigned benefits from 7 practitioners
Practice locations: Flushing, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2283529Michael Li MD PLLC13620 38TH Ave Suite 6F, Flushing, NY 11354ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1508891508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136-20 38 AVE",
            "address_2": "SUITE 6F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544263",
            "telephone_number": "718-888-9700",
            "fax_number": "718-888-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE",
            "address_2": "SUITE 6F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544233",
            "telephone_number": "718-888-9700",
            "fax_number": "718-888-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL LI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-888-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "2148511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02213427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.