Individual provider Active NPI

Douglas Li, MD

  • Pediatrics Physician
  • Santa Monica, CA
National Provider Identifier
1932423225
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A108116 Issued in CA
Practice address
1260 15TH St Ste 1024
Santa Monica, CA 90404-1145
Phone
(310) 825-0867
Fax
(424) 259-8571
NPI assigned
Mar 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X A108116 CA
Pediatrics Physician 208000000X A108116 CA Primary

Addresses

Primary practice location

1260 15TH St Ste 1024
Santa Monica, CA 90404-1145

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

200 Ucla Medical Plz Ste 265
Los Angeles, CA 90095-0001
Phone (310) 825-0867

Other identifiers 1

IdentifierTypeStateIssuer
0A1081160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110713000150 CA Practitioner - Pediatric MedicinePractitioner - Emergency MedicinePractitioner - Pulmonary Disease 9133397490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
82.13
Promoting interoperability
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108116CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatrics CurrentSince Jul 1, 2013 Accepting new patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jul 1, 2011 Accepting new patients
The Regents of the University of California Past Accepting new patients
UCLA Medical Group Pediatrics Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

10833 Le Conte Ave
Ste 265
Los Angeles, CA 90095
Phone (310) 206-3952

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

5767 W Century Blvd
Ste 400000
Los Angeles, CA 90045

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

Interoperability endpoints

  • Direct secure messaging: dli198755@direct.uclahealth.org

Organizations & group practices 5

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": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1932423225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 15TH ST STE 1024",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041145",
            "telephone_number": "310-825-0867",
            "fax_number": "424-259-8571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Ucla Medical Plz Ste 265",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900950001",
            "country_code": "US",
            "telephone_number": "310-825-0867",
            "fax_number": "310-206-5146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A108116",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A108116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1081160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.