Individual provider Active NPI

Jiemin J Li, MD

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1780212449
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A195196 Issued in CA
Practice address
1450 San Pablo St
Los Angeles, CA 90033-5331
Phone
(323) 442-6335
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A195196 CA Primary

Addresses

Primary practice location

1450 San Pablo St
Los Angeles, CA 90033-5331

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240506004259 CA Practitioner - Ophthalmology 2163845918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul T Urrea M D M P H IncGroup PAC ID 9638130735, 7 clinicians

Practice addresses (Care Compare)

1515 N Vermont Ave
Los Angeles, CA 90027-5337
Phone (323) 783-4011

4560 E Cesar E Chavez Ave
Los Angeles, CA 90022-1168
Phone (323) 980-9900

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195196CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Usc Care Medical Group, Inc Ophthalmology CurrentSince Jun 1, 2024 Accepting new patients
Paul T Urrea M D M P H Inc Ophthalmology CurrentSince Aug 1, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 29, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 29, 2025 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-6335

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4560 E Cesar E Chavez Ave
Los Angeles, CA 90022
Phone (323) 269-0411

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1780212449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331",
            "telephone_number": "323-442-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "JIEMIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A195196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.