Individual provider Active NPI

Thomas C Li, M.D.

  • Gastroenterology Physician
  • Fort Lee, NJ
National Provider Identifier
1821053000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA66071 Issued in NJ
Practice address
2231 Lemoine Ave
Fort Lee, NJ 07024-6115
Phone
(201) 944-1008
Fax
(201) 242-0029
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MA66071 NJ Primary

Addresses

Primary practice location

2231 Lemoine Ave
Fort Lee, NJ 07024-6115

Mailing address

2231 Lemoine Ave
Fort Lee, NJ 07024-6115
Phone (201) 944-1008

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
I20141024001226 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 8022283951 Practice locations: Fort Lee, NJ

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Warren Alpert Medical School of Brown University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2231 Lemoine Ave
Fort Lee, NJ 07024-6115
Phone (201) 944-1008

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy61
Upper gastrointestinal (GI) endoscopy for acid reflux78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA66071NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Liao, M.D. L.L.C. Past Accepting new patients

Organizations & group practices 1

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 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821053000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246115",
            "telephone_number": "201-944-1008",
            "fax_number": "201-242-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246115",
            "telephone_number": "201-944-1008",
            "fax_number": "201-242-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA66071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.