Individual provider Active NPI

Michelle Lin

  • Physician Assistant
  • Brookhaven, PA
National Provider Identifier
1629964077
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4808 Edgmont Ave
Brookhaven, PA 19015-1400
Phone
(302) 356-9445
NPI assigned
Jun 13, 2025
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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

4808 Edgmont Ave
Brookhaven, PA 19015-1400

Mailing address

4808 Edgmont Ave
Brookhaven, PA 19015-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250919000421 PA Practitioner - Physician Assistant 1759885981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Demand Urgent Care Group PCGroup PAC ID 5991029712, 95 clinicians

Practice addresses (Care Compare)

1305 W Chester Pike
Havertown, PA 19083-2929
Phone (610) 482-4949

213 Morton Ave
Folsom, PA 19033-3023
Phone (610) 285-9500

3356 Aramingo Ave
Philadelphia, PA 19134-4506
Phone (215) 999-3356

4808 Edgmont Ave
Brookhaven, PA 19015-1400
Phone (610) 876-3072

5828 Market St
Philadelphia, PA 19139-3152
Phone (267) 892-5828

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
On Demand Urgent Care Group PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michelle.lin.1@14965.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1629964077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 EDGMONT AVE",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190151400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 EDGMONT AVE",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190151400",
            "telephone_number": "302-356-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, PA

Sources for this page

Verify at the official NPI Registry.