NPIMap

Individual provider Active NPI

Xiaodong Li, M.D.

  • Pediatrics Physician
  • Fremont, CA
National Provider Identifier
1487738795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A72625 Issued in CA
Practice address
2243 Mowry Ave
Fremont, CA 94538-1630
Phone
(510) 797-7766
Fax
(510) 797-0595
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A72625 CA Primary

Addresses

Primary practice location

2243 Mowry Ave
Fremont, CA 94538-1630

Mailing address

340 W Portola Ave
Los Altos, CA 94022-1122
Phone (650) 948-1882

Other names 1

  • Mrs. Iris Li Other name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A72625CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Hospital Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Triantos MD & Milford MD Inc Pediatrics Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Puri Pediatric Medical Group, Inc. Pediatrics Past Accepting new patients
El Camino Hospital Past Accepting new patients
Pediatric Wellness Group Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: xli166035@direct-ucsfmedicalcenter.org

Organizations & group practices 7

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487738795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W PORTOLA AVE",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221122",
            "telephone_number": "650-948-1882",
            "fax_number": "650-948-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381630",
            "telephone_number": "510-797-7766",
            "fax_number": "510-797-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "XIAODONG",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A72625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRIS",
            "last_name": "LI",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.