Individual provider Active NPI

Xian Min Li, D.O.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1770616864
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243143 Issued in NY
Practice address
1508 Avenue U
Brooklyn, NY 11229-3808
Phone
(917) 754-5781
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243143 NY Primary

Addresses

Primary practice location

1508 Avenue U
Brooklyn, NY 11229-3808

Mailing address

1508 Avenue U
Brooklyn, NY 11229-3808
Phone (917) 754-5781

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
I20070713000641 NY Practitioner - Internal Medicine 9436259801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2010 Bay Ridge Pkwy
Brooklyn, NY 11204-5925
Phone (917) 754-5781

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243143NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chinatown True Care Medical PLLC Internal Medicine CurrentSince Dec 24, 2019 Accepting new patients
Xian Medical Care PC CurrentSince Jun 12, 2020 Accepting new patients
Kings Physician Services, PC Past Accepting new patients

Locations

2002 Bay Ridge Pkwy
Brooklyn, NY 11204
Phone (917) 754-5781

2010 Bay Ridge Pkwy
Brooklyn, NY 11204
Phone (917) 754-5781

833 58th St
Brooklyn, NY 11220
Phone (718) 290-2919

1508 Avenue U
Brooklyn, NY 11229
Phone (347) 673-8000

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1770616864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293808",
            "telephone_number": "917-754-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293808",
            "telephone_number": "917-754-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "XIAN MIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "243143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.