Individual provider Active NPI

Yangjing Lin, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1053085894
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310285 Issued in NY
Practice address
77 Bowery FL 3
New York, NY 10002-4955
Phone
(212) 966-8216
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 310285 NY Primary

Addresses

Primary practice location

77 Bowery FL 3
New York, NY 10002-4955

Mailing address

837 59TH St
Brooklyn, NY 11220-3611
Phone (718) 680-8881

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
I20210907001059 NY Practitioner - Nurse Practitioner 2961808514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
310285NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yong Kang Medical PLLC Multi-Specialty CurrentSince Aug 19, 2021 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Four Season Medical PLLC Multi-Specialty Past Accepting new patients
Well Wellness Medical PLLC Multi-Specialty Past Accepting new patients

Locations

837 59th St
Brooklyn, NY 11220
Phone (718) 975-8415

Networks

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

Interoperability endpoints

  • Direct secure messaging: yangjinglin@mai.allscriptsdirect.net

Organizations & group practices 4

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1053085894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203611",
            "telephone_number": "718-680-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BOWERY FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024955",
            "telephone_number": "212-966-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "YANGJING",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.