Individual provider Active NPI

Enyao Lin

  • Physical Therapist
  • New York, NY
National Provider Identifier
1306739115
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054983 Issued in NY
Practice address
77 Bowery FL 3
New York, NY 10002-4955
Phone
(718) 680-8881
NPI assigned
May 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 054983 NY Primary

Addresses

Primary practice location

77 Bowery FL 3
New York, NY 10002-4955

Mailing address

3151 Knorr St
Philadelphia, PA 19149-2612
Phone (646) 858-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014001975 NY Practitioner - Physical Therapist in Private Practice 1951898956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

837 59TH St
Brooklyn, NY 11220-5576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054983NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Well Wellness Medical PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

837 59th St
Brooklyn, NY 11220
Phone (718) 975-8415

2041 86th St
Brooklyn, NY 11214
Phone (718) 266-2284

Organizations & group practices 1

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": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1306739115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 KNORR ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492612",
            "telephone_number": "646-858-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BOWERY FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024955",
            "telephone_number": "718-680-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "ENYAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.