Individual provider Active NPI

Xin Li, D.O.

  • Physical Medicine & Rehabilitation Physician
  • West Roxbury, MA
National Provider Identifier
1255694550
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
283324 Issued in MA
Practice address
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone
(857) 203-5117
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 252001 MA
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X 283324 MA
Physical Medicine & Rehabilitation Physician 208100000X 283324 MA Primary
Brain Injury Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P0301X DO00864 RI

Addresses

Primary practice location

1400 VFW Pkwy
West Roxbury, MA 02132-4927

Mailing address

1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone (857) 203-5117

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3643

Other practice location 2

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-6177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252001MAMDInternal Medicine Physician
283324MAMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1255694550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-5117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-3643",
            "fax_number": "401-444-0007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-6177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "XIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "252001",
            "primary": false
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "MA",
            "license": "283324",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "283324",
            "primary": true
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "RI",
            "license": "DO00864",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.