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ETHAN LIN
NPI 1790593879
Physician Assistant in Los Gatos, CA

Active since December 20, 2024PECOS Enrolled
640 BLOSSOM HILL RD STE A, LOS GATOS, CA 95032(408) 703-4600 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2025, Dec 20, 2024 (2 updates tracked since 2024).

About Ethan Lin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN LIN (NPI 1790593879) is an individual physician assistant in Los Gatos, California, licensed in California (PA65931) and active in the NPI registry since December 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Irvine.

NPPES Registry Identity

NPI1790593879
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameETHAN LIN
Location Address640 BLOSSOM HILL RD STE ALos Gatos, CA 95032-4564
Mailing Address9401 Jeronimo RdIrvine, CA 92618-1908
Phone(408) 703-4600
Sole ProprietorNo
Enumeration DateDecember 20, 2024
Last NPPES UpdateNovember 17, 20252 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1790593879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA65931
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
640 BLOSSOM HILL RD STE A, Los Gatos, CA 95032
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Secondary Practice Location 1

Location 19401 Jeronimo RdIrvine, CA 92618-1908 · Phone (714) 744-7650

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Lin is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE HUIE
Clinic/Center (Urgent Care)
640 BLOSSOM HILL RD STE A
LOS GATOS, CA 95032
Santa Clara County (408) 645-7073

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Lin's NPI number?

The NPI number for Ethan Lin is 1790593879. It was assigned to this individual provider in the NPPES registry on December 20, 2024.

Where is Ethan Lin located?

Ethan Lin practices at 640 Blossom Hill Rd Ste A, Los Gatos, CA 95032. The listed phone number is (408) 703-4600.

What is Ethan Lin's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ethan Lin enrolled in Medicare?

Yes. Ethan Lin is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Lin was last updated on November 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.