Individual provider Active NPI

George Gang Li, M.D.

  • Specialist
  • Port Charlotte, FL
National Provider Identifier
1871668368
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME99150 Issued in FL
Practice address
4161 Tamiami TRL
Suite 201
Port Charlotte, FL 33952-9204
Phone
(941) 764-0800
Fax
(941) 764-6494
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME99150 FL Primary

Addresses

Primary practice location

4161 Tamiami TRL
Suite 201
Port Charlotte, FL 33952-9204

Mailing address

4161 Tamiami TRL
Suite 201
Port Charlotte, FL 33952-9204
Phone (941) 764-0800

Other identifiers 2

IdentifierTypeStateIssuer
291084500MedicaidFL
279901400MedicaidFL

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
I20080310000476 FL Practitioner - Neurology 7113002528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology PAGroup PAC ID 9335162502, 3 clinicians

Practice addresses (Care Compare)

4161 Tamiami TR
Suite 201
Port Charlotte, FL 33952-9208
Phone (941) 764-0800

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as individual
Quality
77.11
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME99150FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology PA Specialist CurrentSince Sep 17, 2007 Accepting new patients

Locations

4161 Tamiami Trl
Ste 201
Pt Charlotte, FL 33952
Phone (941) 764-0800

Interoperability endpoints

  • Direct secure messaging: george.li.1@20881.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20881/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1871668368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRL",
            "address_2": "SUITE 201",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529204",
            "telephone_number": "941-764-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRL",
            "address_2": "SUITE 201",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529204",
            "telephone_number": "941-764-0800",
            "fax_number": "941-764-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "GEORGE",
        "middle_name": "GANG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME99150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291084500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279901400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.