Individual provider Active NPI

Sherry S Li, M.D., PH.D.

  • Dermatology Physician
  • Flushing, NY
National Provider Identifier
1992742217
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
244852 Issued in NY
Practice address
4160 Main St
Suite 301
Flushing, NY 11355-3833
Phone
(347) 389-3888
Fax
(718) 889-2411
NPI assigned
Jun 2, 2006
Last updated
Mar 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 244852 NY
Dermatology Physician 207N00000X 244852 NY Primary

Addresses

Primary practice location

4160 Main St
Suite 301
Flushing, NY 11355-3833

Mailing address

4160 Main St
Suite 301
Flushing, NY 11355-3833
Phone (347) 389-3888

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080116000117 NY Practitioner - Dermatology 4082684436 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244852NYMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Li Dermatology, PLLC Dermatology CurrentSince May 1, 2011 Accepting new patients
Ny Medical Skin Solutions, PLLC CurrentSince Aug 29, 2024 Accepting new patients
Average Dermatology Nyc PC Past Accepting new patients
New York University PastSince May 1, 2011 Accepting new patients
Delaware Valley Dermatology Group LLC Dermatology Past Accepting new patients
Golden Age Dermatology PLLC Dermatology PastSince Sep 26, 2016 Accepting new patients
Paul Kechijian, MD, PC Dermatology Past Accepting new patients
Atlantic Skin & Cosmetic Surgery Group, P.C. Dermatology Past Accepting new patients

Locations

4160 Main St
Ste 301
Flushing, NY 11355
Phone (347) 389-3888

6666 Grand Ave
Maspeth, NY 11378
Phone (718) 255-5397

345 E 37th St
Rm 301
New York, NY 10016
Phone (212) 867-1020

11412 Beach Channel Dr
Ste 5
Rockaway Park, NY 11694
Phone (718) 634-6885

Networks

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

Organizations & group practices 8

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1992742217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 MAIN ST",
            "address_2": "SUITE 301",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553833",
            "telephone_number": "347-389-3888",
            "fax_number": "718-889-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MAIN ST",
            "address_2": "SUITE 301",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553833",
            "telephone_number": "347-389-3888",
            "fax_number": "718-889-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "SHERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "244852",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "244852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.