Individual provider Active NPI

Connie Huang Lin

  • Acute Care Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1265100317
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95018053 Issued in CA
Practice address
5972 Cerulean Ave
Garden Grove, CA 92845-2620
Phone
(714) 470-5667
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95018053 CA Primary

Addresses

Primary practice location

5972 Cerulean Ave
Garden Grove, CA 92845-2620

Mailing address

5972 Cerulean Ave
Garden Grove, CA 92845-2620
Phone (714) 470-5667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211001000557 CA Practitioner - Nurse Practitioner 1456759646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
California University of Science and Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

1010 W la Veta Ave
Suite 570
Orange, CA 92868-4305
Phone (714) 835-7700

1211 W la Palma Ave
Suite 404
Anaheim, CA 92801-2806
Phone (714) 772-8282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95018053CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Healthcare Partners PC CurrentSince Oct 1, 2022 Accepting new patients
Chest and Critical Care Consultants a Medical Group Acute Care CurrentSince Mar 1, 2025 Accepting new patients
Chest and Critical Care Consultants CurrentSince Mar 1, 2025 Accepting new patients

Locations

1211 W La Palma Ave
Ste 404
Anaheim, CA 92801
Phone (714) 772-1030

225 W Broadway
Ste 350
Glendale, CA 91204
Phone (626) 808-4754

16305 Sand Canyon Ave
Ste 220
Irvine, CA 92618
Phone (909) 558-2840

5451 La Palma Ave
Ste 19
La Palma, CA 90623
Phone (714) 521-9126

3801 Katella Ave
Ste 223
Los Alamitos, CA 90720
Phone (562) 449-4183

4772 Katella Ave
Ste 200
Los Alamitos, CA 90720
Phone (562) 595-9366

1010 W La Veta Ave
Ste 570
Orange, CA 92868
Phone (714) 835-7700

13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200

Interoperability endpoints

  • Direct secure messaging: connie.lin.1@3663.direct.athenahealth.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1265100317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5972 CERULEAN AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452620",
            "telephone_number": "714-470-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 CERULEAN AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452620",
            "telephone_number": "714-470-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "CONNIE",
        "middle_name": "HUANG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95018053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.