Ling Fan

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP011398 Issued in PA

Practice address

111 S 11TH St
Gibbon BLDG., Suite 6270
Philadelphia, PA 19107-4824

Phone

(215) 955-8304

NPI assigned

Oct 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health Mid-Atlantic Medical GroupGroup PAC ID 7416861885, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Newtown, PA, CCN 397015
• Mercy Catholic Medical Center- Mercy Fitzgerald Hospital, Darby, PA, CCN 390156

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lfan2014774@direct.trinity-health.org

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.

• Trinity Health Mid-Atlantic Medical Group

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment Care Compare group NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD
• Trinity Health Mid-Atlantic Medical Group

  • Internal Medicine Physician
  • Richboro, PA
  • NPI 1063830669
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Trauma Surgery Physician
  • Langhorne, PA
  • NPI 1093771271
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Home Health

  • Home Health Agency
  • Newtown, PA
  • NPI 1467412296
  Care Compare affiliation

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1003191883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 6270",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "267-254-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "GIBBON BLDG., SUITE 6270",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "LING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP011398",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00412700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102867945",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Wise LLC
• Familygrouphomecarellc
• Christian Yeong Fan
• Juliana Guo Fan, MD
• Kevin Fan
• Terrence T. Fan, D.M.D
• Wen-Lin Fan, MD
• Xin Fan
• Faramarz Fanaian, DPM
• Alexander C Fanaroff, M.D., M.H.S.

• Acute Care Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.