Active NPI
Man Li Jin
- Ophthalmology Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 4301509565
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2689 - Phone
- (313) 916-3284
- NPI assigned
- Apr 6, 2018
- Last updated
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A176708 | CA | |
| Ophthalmology Physician | 207W00000X | 4301509565 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2689
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-7118
Other practice location 1
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273
Other names 1
- Elina Jin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- State University of New York Downstate Medical Center, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
131 Kercheval Ave
Grosse Pointe Farms, MI 48236-3629
Phone (313) 882-7900
14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone (586) 247-2700
15401 E Jefferson Ave
Grosse Pointe Park, MI 48230-1328
Phone (313) 824-4800
159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610
Phone (313) 640-1000
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 124 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A176708 | CA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Ophthalmology | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Maplegrove Center | Past | Accepting new patients |
Locations
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
2799 W Grand Blvd
#K10
Detroit, MI 48202
Phone (313) 916-3730
Interoperability endpoints
- mjin517935@direct.hfhs.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Detroit, MI
- NPI 1861576266
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
-
dba Henry Ford Health System
- Children's Substance Abuse Rehabilitation Facility
- West Bloomfield, MI
- NPI 1295767630
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
dba Henry Ford West Bloomfield Hospital
- General Acute Care Hospital
- West Bloomfield, MI
- NPI 1407867559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1073010120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-7118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022689",
"telephone_number": "313-916-3284"
}
],
"practiceLocations": [
{
"address_1": "200 W Arbor Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921039000",
"country_code": "US",
"telephone_number": "800-926-8273",
"fax_number": "858-642-3110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JIN",
"first_name": "MAN LI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-06",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A176708",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "4301509565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELINA",
"last_name": "JIN",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.