Active NPI
Paula Lin, M.D.
- Procedural Dermatology Physician
- Fond Du Lac, WI
National Provider Identifier
1942344346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- 52686-20
- Practice address
- 111 Wisconsin American Dr
Fond Du Lac, WI 54937-6725 - Phone
- (920) 923-0788
- Fax
- (920) 686-9674
- NPI assigned
- Feb 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 52686-20 | WI | Primary |
Addresses
Primary practice location
111 Wisconsin American Dr
Fond Du Lac, WI 54937-6725
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 683-5278
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 382000012 | Other | WI | MEDICARE |
| 52686-020 | Other | WI | STATE LICENSE |
| 1942344346 | Medicaid | WI | |
| P00714750 | Other | WI | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52686-20 | WI | MD | Procedural Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paula Lin MD LLC | Procedural Dermatology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Procedural Dermatology Physician
- Orlando, FL
- NPI 1407981400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1942344346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "920-683-5278",
"fax_number": "920-686-9674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 WISCONSIN AMERICAN DR",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549376725",
"telephone_number": "920-923-0788",
"fax_number": "920-686-9674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "PAULA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-18",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "WI",
"license": "52686-20",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "382000012",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "52686-020",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942344346",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00714750",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.