Individual provider Active NPI

Willie Lin

  • Occupational Therapist
  • Montclair, CA
National Provider Identifier
1013625748
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
5350 Olive St
Montclair, CA 91763-1639
Phone
(909) 497-1900
NPI assigned
Nov 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X CA Primary

Addresses

Primary practice location

5350 Olive St
Montclair, CA 91763-1639

Mailing address

5350 Olive St
Montclair, CA 91763-1639

Other practice location 1

4234 Riverwalk Pkwy Ste 200
Riverside, CA 92505-3312
Phone (951) 977-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221206002812 CA Practitioner - Occupational Therapist in Private Practice 3274902655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4234 Riverwalk Pkwy
Suite 200
Riverside, CA 92505-3312
Phone (951) 977-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Physical Therapy and Wellness Center PC Occupational Therapist CurrentSince Oct 1, 2022 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 9, 2023 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 9, 2023 Accepting new patients

Locations

5350 Olive St
Montclair, CA 91763
Phone (909) 295-5900

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

4234 Riverwalk Pkwy
Ste 200
Riverside, CA 92505
Phone (951) 977-2500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1013625748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 OLIVE ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 OLIVE ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631639",
            "telephone_number": "909-497-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4234 Riverwalk Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053312",
            "country_code": "US",
            "telephone_number": "951-977-2500",
            "fax_number": "951-684-1678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "WILLIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.