Individual provider Active NPI

Songjun William Li, MD, PHD

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1326742040
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
82197 Issued in CT
Practice address
300 George St Ste 901
New Haven, CT 06511-6662
Phone
(203) 785-2095
NPI assigned
Mar 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 82197 CT Primary

Addresses

Primary practice location

300 George St Ste 901
New Haven, CT 06511-6662

Mailing address

300 George St Ste 901
New Haven, CT 06511-6662
Phone (203) 785-2095

Other practice location 1

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20251004000111 CT Practitioner - Psychiatry 6901264795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Boston University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1290 Silas Deane Hwy
Hartford, CT 06109

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The William W Backus Hospital Psychiatry CurrentSince Oct 1, 2025 Accepting new patients
The William W Backus Hospital Current Accepting new patients
Natchaug Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
William W Backus Hospital CurrentSince Oct 1, 2025 Accepting new patients
Windham Community Memorial Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: sli617572@direct.ynhh.org

Organizations & group practices 5

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": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1326742040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST STE 901",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116662",
            "telephone_number": "203-785-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GEORGE ST STE 901",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116662",
            "telephone_number": "203-785-2095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Storrs Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield Center",
            "state": "CT",
            "postal_code": "062501683",
            "country_code": "US",
            "telephone_number": "860-456-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "SONGJUN",
        "middle_name": "WILLIAM",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "82197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.