Individual provider Active NPI

Samuel Lin, M.D.

  • Family Medicine Physician
  • Orange, CA
National Provider Identifier
1407910847
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G79985 Issued in CA
Practice address
293 S Main St
Suite 200
Orange, CA 92868-3843
Phone
(714) 838-8848
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G79985 CA Primary

Addresses

Primary practice location

293 S Main St
Suite 200
Orange, CA 92868-3843

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000588 CA Practitioner - Family Practice 8123178621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 5597663641, 61 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79985CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Dec 30, 2014 Accepting new patients
Regents of the University of Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Uci Medical Group Past Accepting new patients
University of California Irvine Past Accepting new patients
Uci Department of Urology Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
University of California Irvine Past Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

293 S Main St
#200
Orange, CA 92868
Phone (714) 838-8848

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

293 S Main St
Orange, CA 92868
Phone (714) 282-9495

293 S Main St
Ste 200
Orange, CA 92868
Phone (714) 838-8848

Organizations & group practices 9

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 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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407910847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 S MAIN ST",
            "address_2": "SUITE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683843",
            "telephone_number": "714-838-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.