Individual provider Active NPI

Lisa Lin, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1669267654
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354889-01 Issued in NY
Practice address
530 1St Ave Ste 8S
New York, NY 10016-6402
Phone
(212) 263-2950
NPI assigned
Apr 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F354889-01 NY Primary

Addresses

Primary practice location

530 1St Ave Ste 8S
New York, NY 10016-6402

Mailing address

25 Christopher Columbus Dr Apt 608
Jersey City, NJ 07302-5119
Phone (917) 292-9980

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
I20250505002023 NY Practitioner - Nurse Practitioner 2062939978 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F354889-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 15, 2025 Accepting new patients
New York University CurrentSince Jun 15, 2025 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

530 1st Ave
Ste 8S
New York, NY 10016
Phone (212) 263-2607

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: llin269555@nyumc.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1669267654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHRISTOPHER COLUMBUS DR APT 608",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025119",
            "telephone_number": "917-292-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE STE 8S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354889-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.