Jay Dean Lincoln

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4105C Issued in AS

Practice address

100 Main Street
Apt 202
Pago Pago, AS 96799-5666

Phone

(684) 699-6380

Fax

(684) 699-6374

NPI assigned

Jun 22, 2018

Last updated

Feb 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• American Samoa Medical Center

  • Internal Medicine Physician
  • Pago, AS
  • NPI 1043085681
  Medicare reassignment NPD

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1609361641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "address_2": "APT 202",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967995666",
            "telephone_number": "684-699-6380",
            "fax_number": "684-699-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "address_2": "APT 202",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967995666",
            "telephone_number": "684-699-6380",
            "fax_number": "684-699-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "JAY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AS",
            "license": "4105C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akosita Lesuma, MBBS
• Senerita Letufuga
• Carrial Edward Leziton, MBBS
• Ianeta Liaina, MBBS
• Emily Lin, PHARM.D.
• Ann Renee Longnecker, CNM-RN
• M&a Medical LLC
• Arnel M Macaballug, M.D.
• Leann Mageo
• Manu'a Medical Center, Inc. (Manu'a Medical)

• Family Medicine Physician in Pago Pago, AS
• Providers in Pago Pago, AS by specialty
• Family Medicine Physician in American Samoa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.