Charles S Li, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME0029731 Issued in FL

Practice address

7647 W Gulf to Lake Hwy
Suite 6
Crystal River, FL 34429-7962

Phone

(352) 795-1718

Fax

(352) 795-7898

NPI assigned

Aug 20, 2006

Last updated

Dec 29, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Cheng Shiumn Li II Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cli296916@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• West Florida Medical Associates, PA

  dba Charles S. Li, MD

  • Rural Health Clinic/Center
  • Crystal River, FL
  • NPI 1457499576

  W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nature Coast Geriatric Services LLC

  • Family Medicine Physician
  • Beverly Hills, FL
  • NPI 1417340654
  Medicare reassignment NPD
• West Florida Medical Associates, PA

  dba Charles S. Li, MD

  • Rural Health Clinic/Center
  • Crystal River, FL
  • NPI 1144355587
  Authorized official Same address or phone
• West Florida Medical Associates, PA

  dba Charles S. Li, MD

  • Rural Health Clinic/Center
  • Crystal River, FL
  • NPI 1457499576
  Authorized official Same address or phone
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1689789380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7647 W GULF TO LAKE HWY",
            "address_2": "SUITE 6",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297962",
            "telephone_number": "352-795-1718",
            "fax_number": "352-795-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7647 W GULF TO LAKE HWY",
            "address_2": "SUITE 6",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297962",
            "telephone_number": "352-795-1718",
            "fax_number": "352-795-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "CHARLES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0029731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "42122",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035298500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660075100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHENG",
            "last_name": "LI",
            "middle_name": "SHIUMN",
            "prefix": "DR.",
            "suffix": "II",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Physician in Crystal River, FL
• Providers in Crystal River, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.