Individual provider Active NPI

Michelle Li

  • Medical Physician Assistant
  • Flushing, NY
National Provider Identifier
1932506094
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
018239 Issued in NY
Practice address
4199 Main St Ste 201
Flushing, NY 11355-5164
Phone
(718) 961-1897
Fax
(718) 766-9749
NPI assigned
Dec 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 018239 NY Primary

Addresses

Primary practice location

4199 Main St Ste 201
Flushing, NY 11355-5164

Mailing address

4199 Main St Ste 201
Flushing, NY 11355-5164
Phone (718) 961-1897

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
I20181026000158 NY Practitioner - Physician Assistant 2860745551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018239NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny Friendly Medical PC CurrentSince Aug 18, 2024 Accepting new patients
Mobile Medical Doc. P.C. Past Accepting new patients

Locations

4199 Main St
Ste 201
Flushing, NY 11355
Phone (718) 961-1897

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1932506094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 MAIN ST STE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555164",
            "telephone_number": "718-961-1897",
            "fax_number": "718-766-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 MAIN ST STE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555164",
            "telephone_number": "718-961-1897",
            "fax_number": "718-766-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "018239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.