Individual provider Active NPI

Luna Li, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Stratford, NJ
National Provider Identifier
1780173633
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA11821500 Issued in NJ
Practice address
18 E Laurel Rd
Stratford, NJ 08084-1327
Phone
(856) 513-4124
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA11821500 NJ Primary

Addresses

Primary practice location

18 E Laurel Rd
Stratford, NJ 08084-1327

Mailing address

24 Hill Farm Way
Woolwich Township, NJ 08085-1376
Phone (121) 599-0702

Other practice location 1

1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone (520) 626-6830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230615001028 NJ Practitioner - Pathology 8123370814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jun 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 1, 2023 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

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.

Hospital & facility affiliations 2

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1780173633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HILL FARM WAY",
            "city": "WOOLWICH TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851376",
            "telephone_number": "121-599-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-513-4124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857240001",
            "country_code": "US",
            "telephone_number": "520-626-6830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "LUNA",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA11821500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.