Individual provider Active NPI

Elizabeth Looney Di, MD

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1568824530
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME154989 Issued in FL
Practice address
304 Ashourian Ave Ste 105
Saint Augustine, FL 32092-5110
Phone
(904) 819-1006
Fax
(904) 819-1008
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.135188 OH
Family Medicine Physician 207Q00000X ME154989 FL Primary

Addresses

Primary practice location

304 Ashourian Ave Ste 105
Saint Augustine, FL 32092-5110

Mailing address

400 Health Park Blvd
Saint Augustine, FL 32086-5784
Phone (904) 819-1006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122001189 FL Practitioner - Family Practice 3577856970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

100 Whetstone PL
Suite 105
Saint Augustine, FL 32086-5775
Phone (904) 824-3777

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

304 Ashourian Ave
Suite 105
Saint Augustine, FL 32092-5110
Phone (904) 819-1006

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154989FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Villages Regional Hospital Physician Services LLC CurrentSince Apr 10, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. Family Medicine CurrentSince Aug 11, 2022 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Aug 11, 2022 Accepting new patients
Flagler Professional Health Care Services, Inc. Family Medicine Past Accepting new patients

Locations

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

304 Ashourian Ave
Ste 105
St Augustine, FL 32092
Phone (904) 819-1006

2570 Race Track Rd
Ste A
St Johns, FL 32259
Phone (904) 819-1005

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: edi741102@direct.shands.ufl.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1568824530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-1006",
            "fax_number": "904-819-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 ASHOURIAN AVE STE 105",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320925110",
            "telephone_number": "904-819-1006",
            "fax_number": "904-819-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI",
        "first_name": "ELIZABETH",
        "middle_name": "LOONEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.135188",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME154989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.