Individual provider Active NPI

Tina Lin, MD

  • Neurological Surgery Physician
  • Cambridge, MA
National Provider Identifier
1447225156
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
215350 Issued in MA
Practice address
300 Mount Auburn St
Ste 416
Cambridge, MA 02138-5600
Phone
(617) 492-7559
Fax
(617) 491-0658
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 215350 MA Primary

Addresses

Primary practice location

300 Mount Auburn St
Ste 416
Cambridge, MA 02138-5600

Mailing address

1 Arsenal Market PL
Watertown, MA 02472-5018
Phone (617) 673-1851

Other identifiers 1

IdentifierTypeStateIssuer
0173169MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20081016000284 CA Practitioner - Neurosurgery 0840358040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

3430 E la Palma Ave
Anaheim, CA 92806-2020
Phone (888) 988-2800

3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-2010

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215350MAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 25, 2007 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 25, 2007 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 21, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 4

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1447225156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ARSENAL MARKET PL",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725018",
            "telephone_number": "617-673-1851",
            "fax_number": "617-499-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST",
            "address_2": "STE 416",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385600",
            "telephone_number": "617-492-7559",
            "fax_number": "617-491-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "215350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173169",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.