Individual provider Active NPI

Jennifer Li

  • Physician Assistant
  • East Meadow, NY
National Provider Identifier
1497105795
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019304 Issued in NY
Practice address
578 Adelphi St
East Meadow, NY 11554-3805
Phone
(516) 862-0200
NPI assigned
Jun 16, 2016
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019304 NY Primary

Addresses

Primary practice location

578 Adelphi St
East Meadow, NY 11554-3805

Mailing address

578 Adelphi St
East Meadow, NY 11554-3805

Other practice location 1

8268 164th St
Jamaica, NY 11432-1121
Phone (718) 883-3177

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228002020 NY Practitioner - Physician Assistant 3375838683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renaissance Medical Care PCGroup PAC ID 1759657927, 5 clinicians
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

1704 Noble St
East Meadow, NY 11554-5007
Phone (516) 862-0200

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019304NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Family Care CurrentSince Oct 3, 2025 Accepting new patients
Renaissance Medical Care, P.C. CurrentSince Oct 3, 2025 Accepting new patients
Parcare Community Health Network Inc CurrentSince Apr 11, 2025 Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

894 Bedford Ave
Brooklyn, NY 11205

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1497105795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 ADELPHI ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115543805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 ADELPHI ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115543805",
            "telephone_number": "516-862-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114321121",
            "country_code": "US",
            "telephone_number": "718-883-3177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.