Individual provider Active NPI

Judith C. Lin, M.D.

  • Vascular Surgery Physician
  • Detroit, MI
National Provider Identifier
1306909932
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301084741 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-9106
Fax
(313) 916-1249
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301084741 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-9106

Other practice location 1

4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383
Phone (517) 267-2460

Other identifiers 4

IdentifierTypeStateIssuer
JL084741OtherCOMMERCIAL-COMMERCIAL NUMBER
JL084741OtherCHAMPUS-CHAMPUS
472453710MedicaidMI
700H262310OtherBLUE CROSS-BLUE CROSS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000459 MI Practitioner - Vascular SurgeryPractitioner - General PracticePractitioner - Peripheral Vascular DiseasePractitioner - General Surgery 4587607288 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Practice, General Surgery, Peripheral Vascular Disease
Education
New York University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

4660 S Hagadorn Rd
Suite 600
East Lansing, MI 48823-5383
Phone (517) 267-2460

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)16
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Current Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University CurrentSince Apr 1, 2020 Accepting new patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University CurrentSince Apr 1, 2020 Accepting new patients
Msu Health Care Inc. Past Accepting new patients
McLaren Greater Lansing Past Accepting new patients

Locations

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 420
East Lansing, MI 48823
Phone (517) 884-6100

4660 S Hagadorn Rd
Ste 600
East Lansing, MI 48823
Phone (517) 267-2460

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

Interoperability endpoints

  • Direct secure messaging: judith.lin.1@25394.direct.athenahealth.com

Organizations & group practices 8

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 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1306909932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-9106",
            "fax_number": "313-916-1249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 S Hagadorn Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488235383",
            "country_code": "US",
            "telephone_number": "517-267-2460",
            "fax_number": "517-884-8602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "JUDITH",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301084741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "JL084741",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "JL084741",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "472453710",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "700H262310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.