Individual provider Active NPI

Tesu Lin, MD

  • Gastroenterology Physician
  • Aiea, HI
National Provider Identifier
1508893496
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD-19780 Issued in HI
Practice address
98-211 Pali Momi St Ste 312
Aiea, HI 96701-4306
Phone
(808) 486-0449
Fax
(808) 756-9552
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD-19780 HI Primary
Gastroenterology Physician 207RG0100X G83685 CA

Addresses

Primary practice location

98-211 Pali Momi St Ste 312
Aiea, HI 96701-4306

Mailing address

98-211 Pali Momi St Ste 312
Aiea, HI 96701-4306
Phone (808) 486-0449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20210211000009 HI Practitioner - Gastroenterology 2062484793 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83685CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Gastroenterology Specialist Gastroenterology CurrentSince Apr 1, 2021 Accepting new patients

Locations

98-211 Pali Momi St
Ste 312
Aiea, HI 96701
Phone (808) 486-0449

Interoperability endpoints

  • Direct secure messaging: tesulin@ivga.allscriptsdirect.net

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1508893496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-211 PALI MOMI ST STE 312",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014306",
            "telephone_number": "808-486-0449",
            "fax_number": "808-756-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-211 PALI MOMI ST STE 312",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014306",
            "telephone_number": "808-486-0449",
            "fax_number": "808-756-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "TESU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD-19780",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G83685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.