Individual provider Active NPI

Kerry Li, DO

  • Family Medicine Physician
  • East Meadow, NY
National Provider Identifier
1144752114
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301556 Issued in NY
Practice address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone
(516) 572-0123
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 301556 NY Primary

Addresses

Primary practice location

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Mailing address

9901 Queens Blvd
Rego Park, NY 11374-4512
Phone (718) 520-6100

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
I20200706002584 NY Practitioner - Family Practice 2365789757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9901 Queens Blvd
Rego Park, NY 11374-4512
Phone (718) 520-6100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Family Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

2520 30th Ave
Fl 4
Long Island City, NY 11102
Phone (718) 808-7777

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

Networks

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

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1144752114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744512",
            "telephone_number": "718-520-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "KERRY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.