Individual provider Active NPI

Eva Li, PA-C

  • Physician Assistant
  • Munster, IN
National Provider Identifier
1679246581
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003347A Issued in IN
Practice address
801 Macarthur Blvd Ste 305
Munster, IN 46321-2920
Phone
(219) 703-2401
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10003347A IN Primary

Addresses

Primary practice location

801 Macarthur Blvd Ste 305
Munster, IN 46321-2920

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210823001348 IN Practitioner - Physician Assistant 0749685287 Reassigns benefits to 1 organization
I20260608001612 IL Practitioner - Physician Assistant 0749685287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians
Cardiothoracic and Vascular Surgical Associates S CGroup PAC ID 7214916402, 48 clinicians

Practice addresses (Care Compare)

1400 S Lake Park Ave
Hobart, IN 46342-6791

1500 S Lake Park Ave
Hobart, IN 46342-6638

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

4400 W 95TH St
Suite 308
Oak Lawn, IL 60453-2660
Phone (708) 346-4040

801 Macarthur Blvd
Munster, IN 46321-2920

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4563

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Physician Assistant CurrentSince Sep 20, 2021 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1400 S Lake Park Ave
Ste 300
Hobart, IN 46342
Phone (219) 942-1169

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

801 MacArthur Blvd
Ste 305
Munster, IN 46321
Phone (219) 703-2401

9120 Columbia Ave
Munster, IN 46321
Phone (219) 513-9415

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Interoperability endpoints

  • Direct secure messaging: eli120866@ssdirect.comhs.org

Organizations & group practices 2

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 4

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": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1679246581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD STE 305",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212920",
            "telephone_number": "219-703-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "EVA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003347A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.