Active NPI
Amy Li, D.M.D.
- Dentist
- Boston, MA
National Provider Identifier
1609187475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1855750
- Practice address
- 145 South St
South Cove Community Health Center
Boston, MA 02111-2826 - Phone
- (617) 521-6760
- NPI assigned
- Jun 28, 2010
- Last updated
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1855750 | MA | Primary |
Addresses
Primary practice location
145 South St
South Cove Community Health Center
Boston, MA 02111-2826
Mailing address
145 South St
South Cove Community Health Center
Boston, MA 02111-2826
Phone (617) 521-6760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160713000617 | MA | Order and Referring Only - Dentist | 0648562579 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1855750 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1609187475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 SOUTH ST",
"address_2": "SOUTH COVE COMMUNITY HEALTH CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "021112826",
"telephone_number": "617-521-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 SOUTH ST",
"address_2": "SOUTH COVE COMMUNITY HEALTH CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "021112826",
"telephone_number": "617-521-6760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "AMY",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-28",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "1855750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.