Active NPI
Eric Lin, MD
- Gastroenterology Physician
- Boston, MA
National Provider Identifier
1104355676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 283208
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (857) 238-3422
- NPI assigned
- Jun 8, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301112192 | MI | |
| Gastroenterology Physician | 207RG0100X | 283208 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
55 Fruit St
Boston, MA 02114-2621
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170630001646 | MI | Order and Referring Only - Internal Medicine | 5799054961 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 283208 | MA | MD | Gastroenterology Physician |
| 4301112192 | MI | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1104355676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "857-238-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-08",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301112192",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MA",
"license": "283208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.