Individual provider Active NPI

James S Lin, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Seattle, WA
National Provider Identifier
1235316712
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD 00048196 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 215-2520
Fax
(206) 215-6364
NPI assigned
Jan 27, 2008
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 059823 GA
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD 00048196 WA Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
194246897DMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlin1042321@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000709 WA Practitioner - Family Practice 1456538404 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
059823GAMDGeriatric Medicine (Family Medicine) Physician
MD 00048196WAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Senior Health Consultants, PLLC Geriatric Medicine CurrentSince Jul 25, 2022 Accepting new patients
Rejuvenation Medical PLLC CurrentSince Jul 25, 2025 Accepting new patients
Caroline Kline Galland Home Past Accepting new patients

Locations

2222 Meridian Ave E
Ste A
Edgewood, WA 98371
Phone (206) 407-4171

12844 Military Rd S
Tukwila, WA 98168
Phone (206) 244-0180

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Caroline Kline Galland HomeSeattle, WA, CCN 505442 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 1, 2022
Jul 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1235316712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-215-2520",
            "fax_number": "206-215-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-27",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "059823",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD 00048196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194246897D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlin1042321@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "747 Broadway",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981224379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.