Individual provider Active NPI

Jinyu Lan

  • Physician Assistant
  • Flushing, NY
National Provider Identifier
1487474615
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13849 62ND Ave # C705
Flushing, NY 11367-1101
Phone
(347) 884-3628
NPI assigned
Oct 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

13849 62ND Ave # C705
Flushing, NY 11367-1101

Mailing address

13620 Maple Ave # C705
Flushing, NY 11355-5166
Phone (718) 888-0316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422000150 NY Practitioner - Physician Assistant 9133644271 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 3

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1487474615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 MAPLE AVE # C705",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555166",
            "telephone_number": "718-888-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13849 62ND AVE # C705",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671101",
            "telephone_number": "347-884-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAN",
        "first_name": "JINYU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.