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DR. KEVIN JAIJIN LI M.D.
NPI 1114377926
Student in an Organized Health Care Education/Training Program in Brockton, MA

Active since June 13, 2016PECOS EnrolledAccepts Medicare Assignment
940 BELMONT ST, PSYCHIATR 116-A7, BROCKTON, MA 02301(405) 223-9935 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 17, 2021, Jun 13, 2016 (2 updates tracked since 2016).

About Dr. Kevin Jaijin Li M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN JAIJIN LI M.D. (NPI 1114377926) is an individual student in an organized health care education/training program in Brockton, Massachusetts and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS and is a graduate of University Of Oklahoma College Of Medicine (2016).

NPPES Registry Identity

NPI1114377926
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KEVIN JAIJIN LICredential: M.D.
Location Address940 BELMONT ST, PSYCHIATR 116-A7Brockton, MA 02301-5596
Mailing Address725 Adams St, Apt 9Boston, MA 02122-1945 · (405) 223-9935
Phone(405) 223-9935
Sole ProprietorNo
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 2016
Enumeration DateJune 13, 2016
Last NPPES UpdateDecember 17, 20212 updates tracked since enumeration
✔ NPI 1114377926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
940 BELMONT ST, Brockton, MA 02301
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Jaijin Li M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739425901
PECOS Enrollment IDI20210609002771
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN ELIZABETH SULLIVAN
Social Worker (Clinical)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
DR. JENI ELAINE NORSTROM PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-2188
JOSEPH KEENE
Licensed Practical Nurse
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-2160
MRS. ROBIN PARENTE R.N.
Registered Nurse (Critical Care Medicine)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (774) 826-1194
DANIELLE NIXON LCSW
Case Manager/Care Coordinator
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
ANAIS LUGO-GUERCIO
Occupational Therapist
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
MRS. TRUDY ROSE RADVILLE OTR/L
Occupational Therapist
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (508) 583-4500
DR. PEGGY MENTOR MD
Family Medicine (Geriatric Medicine)
940 BELMONT ST
BROCKTON, MA 02301
Plymouth County (857) 364-4418

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Li's NPI number?

The NPI number for Kevin Li is 1114377926. It was assigned to this individual provider in the NPPES registry on June 13, 2016.

Where is Kevin Li located?

Kevin Li practices at 940 Belmont St Psychiatr 116-A7, Brockton, MA 02301. The listed phone number is (405) 223-9935.

What is Kevin Li's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kevin Li enrolled in Medicare?

Yes. Kevin Li is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kevin Li was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.