DR. DERRICK T. LIN (M.D.) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1104817170

DR. DERRICK T. LIN (M.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in OTOLARYNGOLOGY. They hold the professional credentials M.D.. They hold a License No. 220903 (MA). The NPI Number for DR. DERRICK T. LIN (M.D.) is 1104817170

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. DERRICK T. LIN (M.D.)
NPI
1104817170
Phone
(617) 523-7900
Address
243 CHARLES ST
Enumeration Date
31 October 2005
Last Update Date
12 March 2014

Doctor Profile

Medical School Name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Secondary Phone
6175237900
Graduation Year
1996 (30 years ago)
PAC ID
7012980337
Group Practice PAC ID
4486540275
Professional Enrollment ID
I20040816000728
Address ID
MA021143002BO243XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

392 OTOLARYNGOLOGY in MA

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Provider Addresses for DR. DERRICK T. LIN (M.D.)

  • Massachusetts Eye and Ear, 243, Charles Street, Beacon Hill, Boston, Suffolk County, Massachusetts, 02114, United States

    BOSTON, MA 021143002

    Phone: (617) 523-7900

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040816000728IOtolaryngologyMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes797484$0
99203New patient office or other outpatient visit, 30-44 minutes9393$0
31575Diagnostic exam of voice box using a flexible endoscope7467$0
38724Removal of lymph nodes, muscle, and tissue of neck2424$0
15100Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less1414$0
View full utilization report →

Insurance plans in this area (ZIP 02114)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486540275View full group profile
NameSpecialtyState
-MA
O P T O M E T R YMA
O P H T H A L M O L O G YMA
-OH
N E U R O L O G YMA
O T O L A R Y N G O L O G YMA
O T O L A R Y N G O L O G YMA
N E U R O L O G YMA
-MA
Diagnostic RadiologyMA

Reviews

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Frequently asked questions

How is DR. DERRICK T. LIN (M.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. DERRICK T. LIN (M.D.) with NPI 1104817170.
Can I rely on DR. DERRICK T. LIN (M.D.) being an active provider?
As of the registry snapshot, DR. DERRICK T. LIN (M.D.) is marked active.
What is DR. DERRICK T. LIN (M.D.)'s specialty?
The listing groups DR. DERRICK T. LIN (M.D.) with Plastic Surgery within the Head & Neck (Otolaryngology) Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. DERRICK T. LIN (M.D.)?
DR. DERRICK T. LIN (M.D.)'s geographic hint is Boston, Massachusetts in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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