Individual provider Active NPI

Xiaoyu Li, M. D, PH. D.

  • Gastroenterology Physician
  • Jacksonville, FL
National Provider Identifier
1790846988
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME92069 Issued in FL
Practice address
6817 Southpoint Pkwy Ste 102
Jacksonville, FL 32216-6285
Phone
(904) 513-3998
Fax
(904) 575-4919
NPI assigned
Dec 12, 2006
Last updated
Aug 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME92069 FL Primary
Hepatology Physician 207RI0008X ME92069 FL

Addresses

Primary practice location

6817 Southpoint Pkwy Ste 102
Jacksonville, FL 32216-6285

Mailing address

6817 Southpoint Pkwy
Ste 102
Jacksonville, FL 32216-6285
Phone (904) 513-3998

Other identifiers 3

IdentifierTypeStateIssuer
2783797-00MedicaidFL
378097680AMedicaidGA
96423OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071011000692 FL Practitioner - Gastroenterology 6709972391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oceanview Medicine, PLLCGroup PAC ID 5597047449, 3 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 102
Jacksonville, FL 32216-6285
Phone (904) 513-3998

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME92069FLMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanview Medicine, PLLC Gastroenterology CurrentSince Nov 1, 2016 Accepting new patients
Phuong Lu DO PA PastSince Nov 1, 2016 Accepting new patients
Physicians Group Services PA Past Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 102
Jacksonville, FL 32216
Phone (904) 513-3998

6817 Southpoint Pkwy
Ste 503
Jacksonville, FL 32216
Phone (904) 296-9777

Interoperability endpoints

  • Direct secure messaging: xli@3232.mdlanddirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1790846988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166285",
            "telephone_number": "904-513-3998",
            "fax_number": "904-575-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166285",
            "telephone_number": "904-513-3998",
            "fax_number": "904-575-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "XIAOYU",
        "credential": "M. D, PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME92069",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "FL",
            "license": "ME92069",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2783797-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378097680A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "96423",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.