Active NPI
Angelina Kim Li
- Social Worker
- New York, NY
National Provider Identifier
1053864827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 590 Avenue of the Americas
New York, NY 10011-2022 - Phone
- (212) 633-9300
- NPI assigned
- Jul 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 091782 | NY | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
590 Avenue of the Americas
New York, NY 10011-2022
Mailing address
2313 41St St
Astoria, NY 11105-1538
Phone (917) 832-0068
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091782 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1053864827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2313 41ST ST",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111051538",
"telephone_number": "917-832-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 AVENUE OF THE AMERICAS",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100112022",
"telephone_number": "212-633-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM LI",
"first_name": "ANGELINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-28",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "091782",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.