Individual provider Active NPI

Jason Li, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1811522584
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
523 E 72ND St
New York, NY 10021-4099
Phone
(212) 606-1052
NPI assigned
Mar 3, 2020
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

523 E 72ND St
New York, NY 10021-4099

Mailing address

1114 72ND St
Brooklyn, NY 11228-1306
Phone (917) 660-0363

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200602000434 NY Practitioner - Physician Assistant 6305267212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York Downstate Medical Center, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11601 Rockaway Beach Blvd
Rockaway Park, NY 11694-2015
Phone (718) 571-9712

1305 Kings Hwy
Brooklyn, NY 11229-1903
Phone (718) 280-5172

2175 86TH St
Brooklyn, NY 11214-3205
Phone (646) 828-6401

2710 Hylan Blvd
Staten Island, NY 10306-4658
Phone (718) 489-3551

3111 Steinway St
Astoria, NY 11103-3908
Phone (718) 475-2345

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

6502 18TH Ave
Brooklyn, NY 11204-3702
Phone (718) 571-9423

812 Forest Ave
Staten Island, NY 10310-2446
Phone (718) 571-9196

8712 4TH Ave
Brooklyn, NY 11209-5110
Phone (718) 530-1155

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024403NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jul 27, 2023 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jul 27, 2023 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: jason.li.1@2983.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1811522584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281306",
            "telephone_number": "917-660-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214099",
            "telephone_number": "212-606-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.