NPIMap

Individual provider Active NPI

David Zheng-Li Xu, M.D.

  • Vascular & Interventional Radiology Physician
  • Dover, DE
National Provider Identifier
1790179927
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
C1-0024137 Issued in DE
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 744-7062
NPI assigned
Mar 25, 2015
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Vascular & Interventional Radiology Physician 2085R0204X C1-0024137 DE Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

331 Justison St Apt 602
Wilmington, DE 19801-5191
Phone (646) 657-8788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810003199 NV Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5991100935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Columbia University College of Physicians and Surgeons, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pueblo Medical Imaging LLCGroup PAC ID 2264328319, 22 clinicians
J Paul Wiesner and Associates CharteredGroup PAC ID 4880679976, 24 clinicians

Practice addresses (Care Compare)

100 N Green Valley Pkwy
Suite 130
Henderson, NV 89014-6392
Phone (702) 228-0031

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J Paul Wiesner & Associates Chartered CurrentSince Aug 8, 2022 Accepting new patients
Pueblo Medical Imaging, LLC CurrentSince Aug 8, 2022 Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074
Phone (702) 990-7417

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

2628 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 644-0500

5495 S Rainbow Blvd
Ste 101
Las Vegas, NV 89118
Phone (702) 214-9729

5495 S Rainbow Blvd
Ste 203
Las Vegas, NV 89118

8551 W Lake Mead Blvd
Ste 150
Las Vegas, NV 89128
Phone (702) 683-5516

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1790179927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 JUSTISON ST APT 602",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015191",
            "telephone_number": "646-657-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "DAVID",
        "middle_name": "ZHENG-LI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "DE",
            "license": "C1-0024137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.