Victor Li MD a Professional Medical

Primary specialty

Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X

License

A77617 Issued in CA

Legal business name

VICTOR LI MD A PROFESSIONAL MEDICAL

Doing business as

Prime Pain Medicine Institute

Practice address

4140 Jade St
Suite 102
Capitola, CA 95010-3956

Phone

(831) 464-7246

Fax

(831) 576-2016

NPI assigned

Dec 5, 2006

Last updated

Oct 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Victor Li, MDNPI 1629150511

Title

MD

Phone

(831) 464-7246

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• PRIME PAIN MEDICINE INSTITUTE Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor Li, MD

  • Pain Medicine (Anesthesiology) Physician
  • Santa Cruz, CA
  • NPI 1629150511
  Medicare reassignment NPD Authorized official
• Daniel Steven Johnson, PA-C, L.AC.

  • Medical Physician Assistant
  • Watsonville, CA
  • NPI 1508151572
  Medicare reassignment
• Amanda Marie Klay, PA-C

  • Physician Assistant
  • Salinas, CA
  • NPI 1144708876
  Medicare reassignment
• Stephen Jacob Pasquini, PA

  • Physician Assistant
  • Santa Cruz, CA
  • NPI 1265418826
  Medicare reassignment
• Ashley Morgan Garrison, PA-C

  • Physician Assistant
  • Edmond, OK
  • NPI 1184142259

  CA

  Medicare reassignment
• Stefan Fred Klein, M.D.

  • Orthopaedic Surgery Physician
  • Santa Cruz, CA
  • NPI 1871664003
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1538227897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 JADE ST",
            "address_2": "SUITE 102",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103956",
            "telephone_number": "831-464-7246",
            "fax_number": "831-576-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 JADE ST",
            "address_2": "SUITE 102",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103956",
            "telephone_number": "831-464-7246",
            "fax_number": "831-576-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR LI MD A PROFESSIONAL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "831-464-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "CA",
            "license": "A77617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A776170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A776170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A77617",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME PAIN MEDICINE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRIME PAIN MEDICINE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawnee Urrere
• Daniele Uzes, L.AC.
• Natalina Valera
• Janeth Vega
• Kahlie Velasco
• Julianne Vilardi-Zelinka, RN, PMHNP
• Raymond A Villaverde, P.A.
• Troy Nicholas Virostko
• John William Visher, PHD
• Visioncare of California (sterling visioncare)

• Anesthesiology Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.