Lin Shan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00045644 Issued in WA

Practice address

1400 N Laventure Rd
Mount Vernon, WA 98273-2766

Phone

(360) 428-4075

Fax

(360) 428-5813

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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 WA

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

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
• Peacehealth United General Medical Center Hospital, Sedro Woolley, WA, CCN 501329

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lshan450844@direct.multicare.org
• Direct secure messaging: lshan12581@skagit.direct-ci.com

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.

• Sea Mar Community Health Centers

  dba Sea Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Lakewood, WA
  • NPI 1699394767

  Family Medicine

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642
  NPD
• Inland Empire Hospital Services Association

  dba Family Medicine of Spokane

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1326002163
  NPD (past)
• Sea-Mar Community Health Center

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1942358817
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba PeaceHealth United General Medical Center

  • Critical Access Hospital
  • Sedro Woolley, WA
  • NPI 1144664954
  Care Compare affiliation
• Public Hospital Dist No 1 Skagit

  dba Skagit Valley Hospital

  • General Acute Care Hospital
  • Mount Vernon, WA
  • NPI 1053357244
  Care Compare affiliation

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780730135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-0112",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732766",
            "telephone_number": "360-428-4075",
            "fax_number": "360-428-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAN",
        "first_name": "LIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00045644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andriian Sereda, MD
• Meri Louise Cruz Serra
• Leanna Joy Long Serrano, MOT, OTR/L
• Carole Sewell, AS, RN
• Jonathan B. Shafer, M.D.
• Shandra Lee DMD PLLC (Mount Vernon Root Canal Specialists)
• Ashley L Shaner, DPT
• Kathleen Shapiro, RPT
• Mariann Shapiro, LMHC
• Marcy A Shapley, PA-C

• Family Medicine Physician in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.