Individual provider Active NPI

Michelle Li, M.D.

  • Adult Medicine Physician
  • New York, NY
National Provider Identifier
1609980044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
197405 Issued in NY
Practice address
420 E 51St St
Office a
New York, NY 10022-8014
Phone
(212) 688-8887
Fax
(212) 688-1243
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 197405 NY Primary

Addresses

Primary practice location

420 E 51St St
Office a
New York, NY 10022-8014

Mailing address

420 E 51St St
Office a
New York, NY 10022-8014
Phone (212) 688-8887

Other identifiers 6

IdentifierTypeStateIssuer
197405A20OtherNYHEALTHFIRST
52772OtherNYGHI HMO
10774POtherNYHIP
P401354OtherNYOXFORD
133887329OtherNYTAX IDENITIFICATION
2C3376OtherNYHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050421001614 NY Practitioner - Family Practice 5890733547 Reassigns benefits to 2 organizations
Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197405NYMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Physicians of Nyc, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Eastside Physicians of Nyc, PLLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

1226 3rd Ave
New York, NY 10021
Phone (212) 757-2015

420 E 51st St
Ste A
New York, NY 10022
Phone (212) 688-8887

715 9th Ave
New York, NY 10019
Phone (212) 757-2015

Practitioners & affiliated clinicians

Practitioners 3

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609980044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 51ST ST",
            "address_2": "OFFICE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100228014",
            "telephone_number": "212-688-8887",
            "fax_number": "212-688-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 51ST ST",
            "address_2": "OFFICE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100228014",
            "telephone_number": "212-688-8887",
            "fax_number": "212-688-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "197405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "197405A20",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "52772",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "10774P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P401354",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENITIFICATION",
            "identifier": "133887329",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C3376",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.