Individual provider Active NPI

Kevin Lin

  • Pharmacist
  • Jamaica, NY
National Provider Identifier
1104284652
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
060920 Issued in NY
Practice address
11510 Merrick Blvd
Jamaica, NY 11434-1852
Phone
(718) 297-8350
NPI assigned
Jan 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 060920 NY Primary

Addresses

Primary practice location

11510 Merrick Blvd
Jamaica, NY 11434-1852

Mailing address

11510 Merrick Blvd
Jamaica, NY 11434-1852
Phone (718) 297-8350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060920NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of New York Inc PastSince Jun 14, 2020 Accepting new patients
Walgreen Co PastSince Jun 14, 2020 Accepting new patients

Organizations & group practices 2

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1104284652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 MERRICK BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341852",
            "telephone_number": "718-297-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 MERRICK BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341852",
            "telephone_number": "718-297-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-28",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "060920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.