Individual provider Active NPI

Haiyan Li, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1871044180
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341157 Issued in NY
Practice address
1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone
(718) 354-8302
NPI assigned
Oct 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341157 NY Primary

Addresses

Primary practice location

1360 Hylan Blvd
Staten Island, NY 10305-1922

Mailing address

1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone (718) 354-8302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180905003064 NY Practitioner - Nurse Practitioner 5395095772 Reassigns benefits to 1 organization
I20200513002572 NJ Practitioner - Nurse Practitioner 5395095772 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F341157NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Spine and Pain Consultant, PLLC CurrentSince Aug 20, 2018 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
St Josephs Medical Group PC CurrentSince Nov 2, 2021 Accepting new patients
St. Joseph'S Healthcare, Inc. CurrentSince Oct 29, 2020 Accepting new patients
Genovese Drug Stores Inc PastSince Aug 20, 2018 Accepting new patients

Locations

1135 Broad St
Ste 1
Clifton, NJ 07013
Phone (973) 754-2196

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

1360 Hylan Blvd
Staten Island, NY 10305
Phone (718) 987-7300

1534 Victory Blvd
Staten Island, NY 10314
Phone (718) 447-0055

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.

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": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1871044180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "718-354-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "718-354-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "HAIYAN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.