NPIMap

Individual provider Active NPI

Jerry W Lin, MD

  • Otolaryngology Physician
  • Louisville, KY
National Provider Identifier
1356464689
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
50410 Issued in KY
Practice address
411 E Chestnut St # Street6
Louisville, KY 40202-1713
Phone
(502) 583-3687
Fax
(502) 588-7840
NPI assigned
Apr 10, 2007
Last updated
May 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X 0101253457 VA
Otolaryngology Physician 207Y00000X N0925 TX
Otology & Neurotology Physician 207YX0901X N0925 TX
Otolaryngology Physician 207Y00000X 50410 KY Primary

Addresses

Primary practice location

411 E Chestnut St # Street6
Louisville, KY 40202-1713

Mailing address

PO Box 776879
Chicago, IL 60677-6379
Phone (502) 588-9490

Other practice location 1

401 E Chestnut St Unit 170
Louisville, KY 40202-5701
Phone (502) 583-3687

Other practice location 2

1000 Breckenridge St Ste 303
Owensboro, KY 42303-0877
Phone (270) 688-2720

Other identifiers 2

IdentifierTypeStateIssuer
7100478670MedicaidKY
214396801MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlin81259@direct.owensborohealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170426001445 KY Practitioner - Otolaryngology 0941399612 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Harvard Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Breckenridge St
Owensboro, KY 42303-0877

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

2211 Mayfair Dr
Owensboro, KY 42301-4569

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50410KYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Otolaryngology CurrentSince Feb 1, 2021 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Owensboro Health Medical Group, Inc Otolaryngology CurrentSince May 13, 2024 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Feb 1, 2021 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince May 13, 2024 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 1, 2017 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 1, 2017 Accepting new patients
Weill Medical College of Cornell Otolaryngology PastSince Jan 1, 2006 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

401 E Chestnut St
Unit 170
Louisville, KY 40202
Phone (502) 583-3277

1050 E Market St
Ste 1
Louisville, KY 40206
Phone (502) 588-8905

310 Whittington Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 429-1249

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

401 E Chestnut St
Unit 710
Louisville, KY 40202
Phone 50258383031332

411 E Chestnut St
#6
Louisville, KY 40202
Phone (502) 588-9587

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

1000 Breckenridge St
Ste 303
Owensboro, KY 42303
Phone (270) 685-2392

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: jlin13818@uoflhealth-dm.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1356464689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776379",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # STREET6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-583-3687",
            "fax_number": "502-588-7840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Chestnut St Unit 170",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402025701",
            "country_code": "US",
            "telephone_number": "502-583-3687",
            "fax_number": "502-588-7840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Breckenridge St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423030877",
            "country_code": "US",
            "telephone_number": "270-688-2720",
            "fax_number": "270-688-2729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "JERRY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "VA",
            "license": "0101253457",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N0925",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "TX",
            "license": "N0925",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "50410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100478670",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214396801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlin81259@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1000 Breckenridge St Ste 303",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423030877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.