Individual provider Active NPI

James Li, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Damariscotta, ME
National Provider Identifier
1699766147
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
016090 Issued in ME
Practice address
35 Miles St
Miles Medical Group
Damariscotta, ME 04543-4047
Phone
(207) 563-4521
Fax
(207) 563-3717
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 016090 ME Primary

Addresses

Primary practice location

35 Miles St
Miles Medical Group
Damariscotta, ME 04543-4047

Mailing address

PO Box 24
Friendship, ME 04547-0024
Phone (207) 691-4366

Other identifiers 2

IdentifierTypeStateIssuer
408440099MedicaidME
3169227MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20040813000717 ME Practitioner - Emergency Medicine 8325011851 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016090MEMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Boston Emergency Physician Foundation, Inc. Past Accepting new patients

Locations

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

24 Miles Center Way
Damariscotta, ME 04543
Phone (207) 563-4250

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1699766147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24",
            "city": "FRIENDSHIP",
            "state": "ME",
            "postal_code": "045470024",
            "telephone_number": "207-691-4366",
            "fax_number": "815-550-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MILES ST",
            "address_2": "MILES MEDICAL GROUP",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434047",
            "telephone_number": "207-563-4521",
            "fax_number": "207-563-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "ME",
            "license": "016090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408440099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3169227",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Damariscotta, ME

Sources for this page

Verify at the official NPI Registry.