Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacy W Li, R-PAC

Individual provider Medical Physician Assistant · NPI 1265789945

Stacy W Li, R-PAC is a Physician Assistant in Elmhurst, New York. Qualified in 2012, 14 years ago. Practices with Metro Dermatology of Ny, PC, an 18-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

4012 80th St
Elmhurst, NY 11373-1234
Phone: (718) 886-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14472 Northern Blvd Ste 203, Flushing, NY 11354-4231 — (718) 886-9000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 015855 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 015855 (NY)

Record details

NPI number1265789945
Entity typeIndividual (Type 1)
GenderFemale
Credentials R-PAC
Sole proprietorNo
NPI enumeratedAugust 13, 2012
Last updated in NPPESFebruary 14, 2022
Certification dateFebruary 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Metro Dermatology Of Ny,P.C. — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Elmhurst