Individual provider Active NPI

Lin-Lin Wang, M.D.

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
National Provider Identifier
1750761268
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
299086 Issued in NY
Practice address
111 Broadway RM 503
New York, NY 10006
Phone
(212) 952-9355
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 299086 NY Primary

Addresses

Primary practice location

111 Broadway RM 503
New York, NY 10006

Mailing address

111 Broadway RM 503
New York, NY 10006-1981

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20211123002950 NJ Practitioner - Physical Medicine and Rehabilitation 1850781360 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299086NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Atlantic Rehabilitation Consultants, LLC Physical Medicine & Rehabilitation CurrentSince Nov 1, 2021 Accepting new patients
Maxwell Medical PC Physical Medicine & Rehabilitation Past Accepting new patients
Maxwell Medical Health, PC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

2 Centre Plz
#F
Tinton Falls, NJ 07724
Phone (732) 460-5360

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1750761268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BROADWAY RM 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROADWAY RM 503",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10006",
            "telephone_number": "212-952-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "LIN-LIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "299086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.