Individual provider Active NPI

Kevin K Li, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Pasadena, CA
National Provider Identifier
1083863690
Registry record updated Oct 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A100695 Issued in CA
Practice address
2555 E Colorado Blvd Ste 306
Pasadena, CA 91107-6648
Phone
(626) 538-8950
Fax
(626) 566-7620
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A100695 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X A100695 CA Primary

Addresses

Primary practice location

2555 E Colorado Blvd Ste 306
Pasadena, CA 91107-6648

Mailing address

2555 E Colorado Blvd Ste 306
Pasadena, CA 91107-6648
Phone (626) 538-8950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100201000257 CA Practitioner - Pain ManagementPractitioner - Anesthesiology 7810030715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Southern California Keck School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2555 E Colorado Blvd
Suite 306
Pasadena, CA 91107-6648
Phone (626) 538-8950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100695CAMDMarriage & Family Therapist
A100695CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Spine Care and Pain Management Current Accepting new patients
Advance Spine Care and Pain Management Anesthesiology CurrentSince Dec 1, 2009 Accepting new patients

Locations

2555 E Colorado Blvd
Ste 306
Pasadena, CA 91107
Phone (626) 538-8950

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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1083863690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 E COLORADO BLVD STE 306",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911076648",
            "telephone_number": "626-538-8950",
            "fax_number": "626-566-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 E COLORADO BLVD STE 306",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911076648",
            "telephone_number": "626-538-8950",
            "fax_number": "626-566-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "KEVIN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A100695",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A100695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.