Individual provider Active NPI

David Lin, M.D.

  • Emergency Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1306227079
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A167318 Issued in CA
Practice address
30 Prospect Ave
3Rd Floor, Main Building Room 3682
Hackensack, NJ 07601
Phone
(551) 996-2331
NPI assigned
Jun 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A167318 CA Primary
Emergency Medicine Physician 207P00000X 25MA10289900 NJ
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

30 Prospect Ave
3Rd Floor, Main Building Room 3682
Hackensack, NJ 07601

Mailing address

30 Prospect Ave
3Rd Floor, Main Building Room 3682
Hackensack, NJ 07601-1915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180712002237 NJ Practitioner - Emergency Medicine 7012263510 Reassigns benefits to 3 organizations
I20230201002658 CA Practitioner - Emergency Medicine 7012263510 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Drexel University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

2500 Grant Rd
Mountain View, CA 94040-4302
Phone (650) 940-7000

Hospital & facility affiliations

  • El Camino Health Hospital, Mountain View, CA, CCN 050308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167318CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Jan 10, 2023 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Ihpnj ER LLC Emergency Medicine CurrentSince Jan 17, 2023 Accepting new patients
El Camino Health Medical Network, LLC CurrentSince Dec 1, 2023 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Garden State Healthcare Associates, LLC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
El Camino Health Medical Group Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

19600 Vallco Pkwy
Ste 170
Cupertino, CA 95014
Phone (650) 338-4776

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

1150 W El Camino Real
Mountain View, CA 94040
Phone (650) 695-5008

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

820 Bear Tavern Rd
Ewing, NJ 08628
Phone (415) 205-1229

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: david.lin@direct.christhospital.md

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1306227079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "3RD FLOOR, MAIN BUILDING ROOM 3682",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "3RD FLOOR, MAIN BUILDING ROOM 3682",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "551-996-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A167318",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10289900",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.