Individual provider Active NPI

Xian Yi Li, AGPCNP

  • Adult Health Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1053135061
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F312054 Issued in NY
Practice address
82-55 Broadway
Elmhurst, NY 11373
Phone
(646) 854-3611
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F312054 NY Primary

Addresses

Primary practice location

82-55 Broadway
Elmhurst, NY 11373

Mailing address

82-55 Broadway
Elmhurst, NY 11373
Phone (646) 854-3611

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
I20250124000806 NY Practitioner - Nurse Practitioner 6507395266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

8255 Broadway
Elmhurst, NY 11373-3362
Phone (646) 854-3611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
312054NYMDPsychiatry Physician
F312054NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chinatown True Care Medical PLLC CurrentSince Mar 1, 2025 Accepting new patients
Chinatown True Care Medical, PLLC PastSince Apr 27, 2016 Accepting new patients

Locations

8255 Broadway
Elmhurst, NY 11373
Phone (347) 749-4808

3808 Union St
Ste 3L
Flushing, NY 11354
Phone (718) 939-5213

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

366 5th Ave
Fl 4
New York, NY 10001
Phone (718) 290-9807

Organizations & group practices 2

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": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1053135061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-55 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "646-854-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-55 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "646-854-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "XIAN YI",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F312054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.